Gabriel Miller; Clifford Hudis, MD


June 26, 2014

In This Article

Health Services Research

Patients' Adherence to Cancer Drugs

Studies using administrative data have shown that many cancer patients fail to take their oral cancer drugs as prescribed, which may lead to worse outcomes in these patients and, in the research context, underestimate the effectiveness of the drugs. Oral abstract 6505 looked at why a group of locally advanced colon cancer patients were not compliant with their recommended treatment schedule.

Of 752 patients, 413 patients were noncompliant using a common administrative data measure, late prescription refills. Overall, 33% of patients' treatment cycles were disrupted.

However, when the study's investigators looked at the patients' medical records, they found that the majority of these disruptions were due to valid reasons, including toxic side effects demanding time off-therapy (50%), physician choice (25%), and travel that required a change in treatment schedule (6%). Ultimately, only 12% of cases were considered true noncompliance.

Dr. Hudis: "This one was interesting from a health services point of view. When readers look at various reports about compliance, probably even outside of oncology, they should realize that the compliance estimates that we get using administrative data, which is what they did here, are probably overestimating noncompliance. That was reassuring on the one hand; but on the other, it means we have a lot more work to do if we're going to understand the problem. I'm not saying that there is no problem; there is."


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