BOA9
Tablet burden in women with metastatic breast cancer (MBC): implications for clinical practice
Anna Dickens1, Christopher Twelves2
1St James's University Hospital, Leeds, UK, 2Leeds Institute of Molecular Medicine, St James's Institute of Oncology, Leeds, UK
Background
With the use of oral anti-cancer drugs increasing, and many patients taking oral concomitant medications, we evaluated ‘tablet burden’.
Method
One hundred women with MBC were interviewed, mean age 59 (range 35-98). We recorded (i) number and nature of tablets, (ii) perceived inconvenience of taking tablets, (iii) self-reported compliance, and (iv) preference for further anti-cancer treatment being a short i.v. infusion or an additional 6 tablets/day, assuming them to be equally effective.
Results
Tablet burden: The tablet number taken/day ranged from 0-31, mean 8.6, median 6; 32% of women took >10 tablets/day and tablet burden was higher in younger women. Analgesics accounted for 40% of tablets with endocrine therapy and oral chemotherapy contributing 15%; 28% of tablets were concomitant medicines e.g. statins.
Compliance: Most (62%) reported full compliance, 24% omission once/week and 8% more often. Compliance did not differ between those taking <10 tablets and ≥10 tablets/ day.
Convenience: Most (68%) reported oral medication as not being inconvenient, 14% reporting inconvenience as ‘slight’ and 12% as ‘very’. Inconvenience was greater in women taking ≥10 tablets/day.
Preference: Half (53%) would prefer additional oral to i.v. therapy, the remainder would prefer i.v. (34%) or had no preference (13%). Preference was not affected by tablet burden. Reasons for preferring oral included difficult i.v. access (31%), convenience (27%) and experience (9%).
Conclusion
Tablet burden is high in many women with MBC. Although good compliance is claimed, many women find oral medication inconvenient, especially if taking ≥10 tablets/day. Although most women would opt for oral rather than i.v. cancer therapy, 1/3rd would prefer i.v. and preference was not affected by tablet burden. Oncologists should critically evaluate the need for concomitant medicines in women with MBC and where appropriate offer the choice between oral and i.v. anti-cancer therapy.
