{
  "abstract": "Background and Importance Adherence to oral oncologic therapy is crucial to achieve therapeutic goals. However, long-term treatments in elderly patients may reduce adherence, particularly when the dosing regimen is complex.Aim and Objectives The objective of this study was to assess whether simplifying the dosing regimen (four 60 mg tablets vs one 240 mg tablet once daily) could influence adherence to apalutamide treatment in patients with metastatic hormone-sensitive prostate cancer (mHSPC).Material and Methods A single-centre observational study was conducted between April and December 2024. Patients diagnosed with mHSPC receiving full-dose apalutamide and followed in the outpatient oncology pharmacy unit were included if they initially received the 60 mg presentation (four tablets daily) and later switched to the 240 mg presentation (1 tablet daily).Exclusion criteria were: language barrier, end-of-life situation, treatment change due to disease progression, and dose reduction due to toxicity.Sociodemographic (age) and pharmacotherapeutic data (treatment duration, polypharmacy, adverse reactions, adherence, administration) were collected through in-person or telephone interviews with patients and/or caregivers, and by reviewing electronic medical records.Adherence was assessed using the Morisky-Green questionnaire (MMAS-4). Patients were considered adherent if they answered correctly to all four questions (No/Yes/No/No). The questionnaire was first administered with the 60 mg presentation and later after switching to the 240 mg tablet. In non-adherent patients, adherence-enhancing strategies were implemented (pill organisers, mobile phone reminders).Results 37 patients were interviewed, with a median age of 71 years (interquartile range 66–78). The mean duration of apalutamide treatment was 773 days. Polypharmacy was observed in 84% of patients, 81% were over 65 years old, and 35% reported adverse reactions, mainly fatigue, hot flashes, and pruritus.According to Morisky-Green questionnaire responses, adherence was 81% with the 60 mg (four-tablet) presentation and 89% with the 240 mg (1 tablet) presentation. Regarding administration, 100% of patients reported greater convenience with the single-tablet regimen and no difficulty swallowing it, despite its larger size compared with the 60 mg tablets.Conclusion and Relevance Optimising the dosing regimen by reducing tablet burden, together with the use of adherence-enhancing strategies, may have positively contributed to improved treatment adherence.References and/or Acknowledgements 1. EuropeanPublicAssessmentReport(EPAR) de Erleada (apalutamida). Procedimiento: EMEA/H/C/004452/II/0001. https://www.ema.europa.eu/en/documents/variation-report/erleada-h-c-4452-ii-0001-epar-assessment-report-variation_en-0.pdf2. Ficha técnica de Erleada (apalutamida). https://www.ema.europa.eu/en/documents/product-information/erleada-epar-product-information_es.pdfConflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital General Universitario Santa Lucía, Farmacia Hospitalaria, Cartagena, Spain"
      ],
      "name": "ME Martínez Madrid"
    },
    {
      "affiliations": [
        "Hospital General Universitario Santa Lucía, Farmacia Hospitalaria, Cartagena, Spain"
      ],
      "name": "EJ Sevilla Alarcón"
    },
    {
      "affiliations": [
        "Hospital General Universitario Santa Lucía, Farmacia Hospitalaria, Cartagena, Spain"
      ],
      "name": "Á Varea Bejar"
    },
    {
      "affiliations": [
        "Hospital General Universitario Santa Lucía, Farmacia Hospitalaria, Cartagena, Spain"
      ],
      "name": "F Lago Ballester"
    },
    {
      "affiliations": [
        "Hospital General Universitario Santa Lucía, Farmacia Hospitalaria, Cartagena, Spain"
      ],
      "name": "JM Moya Flores"
    },
    {
      "affiliations": [
        "Hospital General Universitario Santa Lucía, Farmacia Hospitalaria, Cartagena, Spain"
      ],
      "name": "Y Marín andreu"
    }
  ],
  "title": "4CPS-329 Evaluation of adherence to apalutamide treatment in patients with metastatic hormone-sensitive prostate cancer",
  "uid": "9d7a1cad-b393-5561-931a-ddde847af181"
}