Adherence to Capecitabine Treatment and Contributing Factors among Cancer Patients in Malaysia

  • Zahrina, Abdul Kadir (Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia) ;
  • Norsa'adah, Bachok (Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia) ;
  • Hassan, Norul Badriah (Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia) ;
  • Norazwany, Yaacob (Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia) ;
  • Norhayati, Md Isa (Department Pharmacy, Hospital Sultan Ismail) ;
  • Roslan, Mohd Haron (Department Oncology and Radiotherapy, Hospital Sultan Ismail) ;
  • Wan Nazuha, Wan Rusik (Oncology and Radiotherapy Institute, Hospital Kuala Lumpur)
  • Published : 2014.11.28


Ensuring adherence to chemotherapy is important to prevent disease progression, prolong survival and sustain good quality of life. Capecitabine is a complex chemotherapeutic agent with many side effects that might affect patient adherence to treatment. This cross sectional study aimed to determine adherence to capecitabine and its contributing factors among cancer outpatients in Malaysia. One hundred and thirteen patients on single regime capecitabine were recruited from Hospital Sultan Ismail and Hospital Kuala Lumpur from October 2013 to March 2014. Adherence was determined based on adherence score using validated Medication Compliance Questionnaire. Patient socio-demographics, disease, and treatment characteristics were obtained from medical records. Satisfaction score was measured using the validated Patient Satisfaction with Healthcare questionnaire. The mean adherence score was 96.1% (standard deviation: 3.29%). The significant contributing factors of adherence to capecitabine were Malay ethnicity [${\beta}=1.3$; 95% confidence interval (CI): 0.21, 2.43; p value=0.020], being female [${\beta}=1.8$; 95%CI: 0.61, 2.99; p value=0.003]), satisfaction score [${\beta}=0.08$; 95%CI: 0.06, 1.46; p value=0.035], presence of nausea or vomiting [${\beta}=2.3$; 95%CI: 1.12, 3.48; p value <0.001] and other side effects [${\beta}=1.45$; 95%CI: 0.24, 2.65; p value=0.019]. Adherence to capecitabine was generally high in our local population. Attention should be given to non-Malay males and patients having nausea, vomiting or other side effects. Sufficient information, proactive assessment and appropriate management of side effects would improve patient satisfaction and thus create motivation to adhere to treatment plans.


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