Patient–doctor relationship and adherence to capecitabine in outpatients of a German comprehensive cancer center

Abstract

Jochen Hefner,1 Sara Berberich,2 Elena Lanvers,3 Maria Sanning,4 Ann-Kathrin Steimer,5 Volker Kunzmann6 1Section of Psychosomatic Medicine, Department of Internal Medicine II, University of Wuerzburg, Bavaria, Germany; 2Medical Student, Faculty of Medicine, University of Wuerzburg, Bavaria, Germany; 3Intensive Care Unit, Children’s Hospital of the City of Cologne, North Rhine-Westphalia, Germany; 4Department of Internal Medicine II, St Johannes Hospital Dortmund, North Rhine-Westphalia, Germany; 5Catholic Children’s Hospital Wilhelmsstift, Hamburg, Germany; 6Section of Clinical Oncology, Department of Internal Medicine II, University of Wuerzburg, Bavaria, Germany Purpose: The prescribing of oral chemotherapy agents has introduced the new challenge of ensuring patients’ adherence to therapy. Aspects of a close patient–doctor relationship are reported to be correlated with adherence to oral anticancer drugs, but data on capecitabine are scarce.Patients and methods: Sixty-four outpatients with a diagnosis of cancer and prescribed capecitabine were recruited from a German Comprehensive Cancer Center. We used the Patient–Doctor Relationship Questionnaire (PDRQ-9), the Medical Adherence Rating Scale (MARS), the Beliefs about Medicines Questionnaire (BMQ), and the Satisfaction with Information about Medicines Scale (SIMS) to assess patients’ perceptions and behavior. Medical data were extracted from the charts.Results: Non-adherence was reported by 20% of the 64 participants. The perceived quality of the patient–doctor relationship was high in general, but it did not emerge as a predictor of adherence in our survey (odds ratio [OR]=0.915, P=0.162, 95% CI=0.808–1.036). However, beliefs about medicine (OR=1.268, P<0.002; 95% CI=1.090–1.475) as well as satisfaction with information about medicine (OR=1.252, P<0.040, 95% CI=1.010–1.551) were predictors of adherence and the quality of the patient–doctor relationship was correlated with both variables (r=0.373, P=0.002 for SIMS sum score; r=0.263, P=0.036 for BMQ necessity/concern difference). Overall, adherence to capecitabine was high with a conviction that the therapy is necessary. However, concerns were expressed regarding the long-term effect of capecitabine use. Patients have unmet information needs regarding interactions of capecitabine with other medicines and the impairment of their intimate life.Conclusions: In order to ensure adherence to capecitabine, our results seem to encourage the default use of modern and perhaps more impersonal means of information brokerage (eg, email, internet). However, the contents of some of patients’ informational needs as well as the associations of patients’ beliefs and satisfaction about the information received suggest a benefit from a trustful patient–doctor relationship. Keywords: oral anticancer drugs, capecitabine, adherence, patient–doctor relationship, beliefs in medication, satisfaction with information about medicines

Keywords

• Oral anticancer drugs – Capecitabine – Adherence – Patient-doctor relationship – Beliefs in Medication – Satisfaction with information about Medicines