Journal of Clinical Oncology, Vol 10, 1007-1013, Copyright © 1992 by American Society of Clinical Oncology
Patient compliance with oral chemotherapy as assessed by a novel electronic technique
CR Lee, PW Nicholson, RL Souhami and AA Deshmukh
Department of Pharmaceutics, School of Pharmacy, University College and Middlesex School of Medicine, London, United Kingdom.
PURPOSE: Previous reports have suggested low rates of compliance with the
oral component of cancer chemotherapy, which, if confirmed, would have
serious implications on treatment. Because of the uncertainties in the
methodology used in previous studies, we have assessed compliance with a
novel technique. PATIENTS AND METHODS: An "intelligent" tablet bottle was
used, which, unknown to the patient, electronically records the times of
opening over a period of weeks. The records were scored for overall
compliance (total number of bottle openings as a percentage of the
prescribed number) and for daily and hourly irregularity indices.
Twenty-one patients undergoing treatment for Hodgkin's or non- Hodgkin's
lymphoma were monitored for a total of 65 treatment periods, each of up to
2 weeks (852 days in total). Eight measures of side effects and quality of
life were self-assessed daily by the patients using a diary card. RESULTS:
The overall compliance was 100.6% +/- 20.6% (mean +/- SD). Overall
compliance was lower (mean reduction, 10%) in treatment periods with drugs
prescribed to be taken three times a day. It was not possible to
demonstrate convincingly any relationship between compliance and any of the
following: drug type, monitoring period sequence, the diary card scores of
side effects and quality of life, number of relapses, and time since
initial diagnosis. CONCLUSION: These results are reassuring, but further
work is in progress to measure compliance in other treatment regimens in
which the side effects are more severe and the prognosis is worse.
