1611P - Improving patient adherence by using the flowchart type leaflet

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Patient Education and Advocacy
Presenter Shinya Suzuki
Authors S. Suzuki1, M. Yoshida2, Y. Yajima3, T. Kobayashi3, S. Kobayashi2, T. Enokida3, H. Ishiki3, K. Endo4, K. Izumi2, M. Tahara5
  • 1Pharmacy Dept., National Cancer Center Hospital East, JP-277-8577 - Kashiwa/JP
  • 2Pharmacy, National Cancer Center Hospital East, JP-277-8577 - Kashiwa/JP
  • 3Head And Neck Medical Oncology, National Cancer Center Hospital East, 2778577 - Kashiwa/JP
  • 4Drug Safety Management, Meiji Pharmaceutical University, 204-8588 - Tokyo/JP
  • 5Head And Neck Medical Oncology, National Cancer Center Hospital East, JP-277-8577 - Kashiwa/JP



Most information sheets cover the schedule of chemotherapy sessions and the adverse reactions of the respective drugs. However, the leaflets do not provide enough information instructing them how to take their supportive medications while at home for patients that have adverse drug reactions. We have developed a flowchart type leaflet to help improve the patients' adherence. The flowchart consisted of yes/no questions to guide how to take supportive medicine for adverse drug reactions or when patients should call to a hospital.


This study was designed to evaluate the benefits associated with the flowchart type leaflet (FC). [Subjects and methods] Subjects include head and neck cancer inpatients who received induction chemotherapy, TPF (docetaxel, cisplatin, and 5FU) or TPS (docetaxel, cisplatin, and S-1), from September 2009 to April 2012. Group A used FC while Group B did not use FC in their chemotherapy. A retrospective study was performed using patient records. The endpoints of this study were: (1) To determine the emergency hospital admissions/visits, (2) To determine the nonadherence, (3) To determine the telephone calls from patients.


There were 49 patients and a total of 139 chemotherapy sessions in group A while there were 60 patients and a total of 163 chemotherapy sessions in group B with no significant differences in age, performance status, and their chemotherapy regimen. The results are: (1) Incidence of emergency hospital admission was significantly lower in group A compared to group B. (Group A v.s. Group B: 1% v.s. 10%, p < 0.01) (2) The nonadherence rate in supportive medication for adverse drug reactions due to chemotherapy was significantly lower in group A than group B (Group A v.s. Group B: 5% v.s. 23%, p < 0.01). (3) Telephone call rates were statistically significant in group A (16%, total 30 calls) compared to group B (7%, total 11 calls) in each chemotherapy regimen. Of the 30 telephone calls in group A, 24 calls (80%) were in a situation where patients needed to call a hospital and 5 calls (45%) in group B.


The FC could contribute to reducing emergency hospital admissions to prevent nonadherence and encourage patients' judgments in chemotherapy.


All authors have declared no conflicts of interest.