Taxifolin  small and drawn from a single UK hospital, and thus larger sample sizes and further multicenter studies are necessary to produce more generalizable results. The clinical and demographic characteristics of the sample are, however, typical for capecitabine, with most patients receiving it as first line treatment and the majority for less than 6 months which is expected given that the licensed treatment schedule for colon, colorectal and breast cancer is 6 months, and thus it affords some confidence in the generalizability of these results.The high patient reported adherence is in accordance with previous capecitabine studies using MEMS.

However, self-reported adherence ratings should be treated with caution due to peptide synthesis self-presentation bias often resulting in overestimation.The higher capecitabine adherence rates relative to other chemotherapeutic agents such as tamoxifen is, however, interesting. This may be partly attributable to the shorter treatment period of capecitabine relative to other chemotherapeutic agents as adherence declines with time.It may also be a result of the more intensive monitoring associated with capecitabine therapy.While the low non-adherence rate is encouraging, even at low levels, the clinical impact may be significant given that unlike many other non-chemotherapeutic agents, dosing is accurately calculated based on surface area; thus, small deviations may decrease efficacy to the extent of treatment failure while overdoses may increase the likelihood of dose-dependent purchase Polydatin adverse effects.

The non-adherence reported was primarily ‘forgetting’ which research has demonstrated participants deem more socially acceptable to report than intentional behaviors such as missing or altering doses.However, the barriers to adherence reported, such as difficulty remembering the time of day and problems accessing the medication from the packaging order Biochanin A reinforce the notion of true unintentional non-adherence. It may therefore be appropriate to explore with patients any problems that they may be experiencing with remembering to take their medication. Various approaches have been proposed to address such unintentional nonadherence such as memory cues, multi-compartment medication devices or medication supply in easily accessible packaging.The prevalence of participant reported side effects mirror those listed in the manufacturer’s data sheet which again provides greater confidence in the generalizability of the results of this patient population. It is reassuring to know that participants did inform clinicians of their side effects as demonstrated by the large proportion recorded in medical notes.

Contrary results were presented in 2002 indicating that patients were reluctant to report Lyceum side effects to clinicians and that in many cases if known, they could have been treated.45 While diarrhea was the most prevalent side effect, nausea was reported by more participants to be troubling and thus early advice from clinicians regarding the available strategies to manage nausea may be advisable. However, the side effects that most notably bothered patients, were PPE and tiredness which may be a reflection of the limited available interventions .