# Tablet Acceptability in Older Outpatients Undergoing Cancer Chemotherapy

## TL;DR

This study explores how older cancer patients accept tablets, finding that women and those on many medications have more difficulty, suggesting early interventions could improve treatment adherence.

## Contribution

The study identifies female sex and polypharmacy as independent factors linked to poor tablet acceptability in older cancer patients.

## Key findings

- Female sex and polypharmacy were independently associated with poor tablet acceptability.
- Subjective difficulty in chewing was also linked to poor tablet acceptability.
- Early multidisciplinary intervention may help maintain tablet acceptability and improve adherence.

## Abstract

Background/Objectives: Patient acceptability of oral anticancer drugs is a critical factor that influences treatment in older outpatients receiving cancer chemotherapy and plays a central role in enhancing adherence and treatment effectiveness. Identifying older outpatients receiving cancer chemotherapy who exhibit poor tablet acceptability before initiating oral anticancer therapy and offering alternative treatment options are beneficial. Therefore, we investigated the characteristics of patients with poor tablet acceptability by focusing on the tablet size, geriatric assessment, and polypharmacy. Methods: A questionnaire survey on experiences with tablet medication was conducted among patients who received chemotherapy at the Outpatient Treatment Center of Tokyo Metropolitan Bokutoh Hospital from September 2024 to September 2025. The median values of the long diameter (12 mm) and the combined length, width, and thickness (26 mm) of the tablets reported as acceptable in the questionnaire described in Method 1 were used as cutoff values. Patients whose reported acceptable tablet dimensions were below these median values were classified as “poor tablet acceptability,” whereas those with values above the median were classified as “good tablet acceptability”. Univariate and multivariate logistic regression analysis was performed to identify characteristic factors associated with poor tablet acceptability in older outpatients receiving cancer chemotherapy, with poor tablet acceptability as the dependent variable and patient sex, body mass index, Geriatric 8 score, each item of the Oral Frailty 5-item Checklist, and polypharmacy as explanatory variables. Results: 90 patients completed the questionnaire survey. Female sex and polypharmacy were independent factors associated with poor tablet acceptability in older outpatients receiving cancer chemotherapy. In addition, subjective difficulty in chewing tended to be associated with poor tablet acceptability. Conclusions: This study suggests that assessing polypharmacy and oral function, along with early multidisciplinary intervention before and during oral anticancer therapy, particularly in females, patients taking multiple medications, and those reporting difficulty in chewing, may help maintain tablet acceptability and improve adherence.