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There's many a slip twixt cup and lip: adherence issues in cancer therapy

Nature Clinical Practice Oncology volume 5, pages 118–119 (2008)Cite this article

The past decade has seen many exciting advances in cancer treatment, with patients worldwide experiencing worthwhile remissions, longer lives, or cure of their disease. Concerns exist about the affordability and availability of novel treatments, but patients who do receive expensive drugs often fail to take them. This dire waste of valuable resources merits further examination. Many chemotherapy agents are now given orally rather than intravenously, and so ensuring adherence to these medications is as fundamental to successful cancer treatment as is the development of new therapies. This Viewpoint challenges the assumption that individuals with life-threatening disease automatically adhere to oral therapy, and explores reasons for nonadherence.

Nonadherence has been reported consistently across a wide distribution of health-care settings and among patients from different age groups, socioeconomic and educational backgrounds and ethnic groups, with different medical conditions. Measuring adherence includes taking pill counts, monitoring prescriptions collected from the pharmacy, analyzing drug levels in the blood and obtaining patient self reports. Estimates vary depending on the measurement used, but 20–80% of patients are reported as nonadherent. The complex behavioral processes that underpin adherence and noncompliance have been afforded little attention by oncologists.1 Some clinicians see noncompliance simply as a failure to follow instructions rather than an active, reasoned decision by the patient.2

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Author notes

  1. Cancer Research UK Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Falmer BN1 9QG, UK l.j.fallowfield@sussex.ac.uk

Authors and Affiliations

  1. L Fallowfield is Director of the Cancer Research UK Sussex Psychosocial Oncology Group at Brighton & Sussex Medical School, University of Sussex, Falmer, UK.,

    Lesley Fallowfield

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  1. Lesley Fallowfield
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The author declares no competing financial interests.

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Fallowfield, L. There's many a slip twixt cup and lip: adherence issues in cancer therapy. Nat Rev Clin Oncol 5, 118–119 (2008). https://doi.org/10.1038/ncponc1043

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