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Adherence with capecitabine: A population-based analysis based on prescription refill data.
Laurel Kovacic1, Neil de Haan1, Mário L de Lemos1
1Provincial Pharmacy, Systemic Therapy Program, BC Cancer Agency, Vancouver, Canada.
Summary
Patient adherence to oral anticancer drugs like capecitabine is crucial. Analyzing prescription refill data using a computer algorithm and manual review offers an objective method to assess adherence rates, revealing high consistency with patient self-reports.
Area of Science:
- Oncology
- Pharmacology
- Health Informatics
Background:
- Patient adherence to oral anticancer medications is critical.
- Previous adherence studies used self-reporting or microelectronic monitoring, which may be confounded by patient awareness.
- Prescription records offer a larger, more objective dataset for adherence investigation.
Purpose of the Study:
- To determine the rate of capecitabine adherence using prescription and medical documentation.
- To evaluate the utility of a computer algorithm and manual review for adherence assessment.
Main Methods:
- Reviewed two years of capecitabine prescription records from five ambulatory cancer centers.
- Utilized a custom Java-based software tool to extract prescription data and compare predicted vs. actual dispensing dates.
- Estimated adherence using a computer algorithm and manual chart review to identify "altered treatment date incidents".
Main Results:
- Initially, 45.2% of 4412 refill prescriptions showed an altered treatment date incident via computer algorithm.
- This rate decreased to 29.5% after adjusting for clinic scheduling and 10.2% after manual chart review for valid delays.
- Reasons for altered treatment dates were unidentified in 52.2% of prescriptions.
Conclusions:
- Capecitabine adherence rates derived from prescription refill data appear high and align with self-report findings.
- Population analysis of prescription data with algorithms can efficiently identify adherence trends, but manual review is likely needed for verification.
- Further studies are required to confirm the accuracy of using altered prescription refill dates as an adherence measure.
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