Examining Oral Anti-Cancer Medication Continuation Using Questionnaires, Prescription Refills, and Structured Electronic Health Records.

Abstract

Medication persistence is essential for the efficacy of treatment and patient health outcomes. This study investigates the discontinuation of oral anticancer medications (capecitabine, ibrutinib, or sunitinib) in a cohort that is well-characterized by medication discontinuation survey questionnaires, prescription refill data, and structured electronic health records (EHRs). We categorized discontinuation reasons based on a survey of patients taking medication, revealing that 38% of 257 patients completed therapy, while discontinuation was due primarily to no response to therapy and/or progression of disease leading to discontinuation (33%) and side effects/complication (9%). Survival analysis showed variable medication persistence, with capecitabine persistence decreasing significantly over time, to 0.08 in two years. A logistic regression model demonstrated strong capability (with an AUC of 0.835) to identify patients at risk for medication discontinuation. Our study shows the complexities of medication persistence and emphasizes the importance of understanding medication discontinuation patterns and leveraging predictive analytics to inform future research and clinical monitoring in the treatment of cancer.