Medicine and Health Sciences Commons^™

An Intervention To Improve Adherence And Management Of Symptoms For Patients Prescribed Oral Chemotherapy Agents: An Exploratory Study, Sandra L. Spoelstra, Barbara A. Given, Charles W. Given, Marcia Grant, Alla Sikorskii, Mei You, Veronica Decker

Peer Reviewed Articles

Background: The use of oral chemotherapy agents to treat cancer has increased. Patients are responsible for adhering to complex dosing regimens, while monitoring and managing symptoms from side effects of the chemotherapy at home.

Objective: This study examined an intervention to manage symptoms and promote adherence to oral chemotherapy agents.

Intervention and Methods: A 3 group exploratory pilot study determined how an Automated Voice Response (AVR) system alone (N=40), or the AVR with strategies to manage symptoms and adherence (N=40), or the AVR with strategies to manage adherence (N=39) reduced symptom severity and improved adherence. Participants received a Symptom Management …

The Challenges Of Oral Agents As Antineoplastic Treatments, Barbara A. Given, Sandra L. Spoelstra, Marcia Grant

Peer Reviewed Articles

OBJECTIVE: Given the increasing use of oral antineoplastic agents in cancer management, patient adherence is critical to successful treatment outcomes. This article reviews the scope of the problem and issues of adherence to oral antineoplastic agents.

DATA SOURCES: Research based and other articles, newsletters, and conference presentations.

CONCLUSION: Suboptimal adherence to oral antineoplastic agents is a significant clinical problem that may result in disease or treatment complications, adjustment in treatment regimen, disease progression, and premature death.

IMPLICATIONS FOR NURSING PRACTICE: Healthcare providers need to monitor and facilitate adherence by identifying barriers and implementing strategies to assure adherence, and therefore, improve …

Assessment And Measurement Of Adherence To Oral Antineoplastic Agents, Sandra L. Spoelstra, Charles W. Given

Peer Reviewed Articles

OBJECTIVES: The increase in oral anticancer medications with complex regimens creates a need to assure patients are taking therapeutic dosages as prescribed. This article reviews the assessment and measurement of adherence to oral antineoplastic agents.

DATA SOURCE: Research and journal articles from CINAHL and Pub Med.

CONCLUSION: Assessing and measuring adherence to oral antineoplastic should include three dimensions: the percentage of medications taken, the duration, and the timing of taking the medication.

IMPLICATIONS FOR PRACTICE: Clinicians need to conduct ongoing assessment and measurement of adherence to oral antineoplastic agents. This includes eliciting patient report of adherence, pill counts, drug diaries, …

Policy Implications Of Oral Agents, Sandra L. Spoelstra, Barbara A. Given, Charles W. Given, Marcia Grant

Peer Reviewed Articles

OBJECTIVE: With the increasing use of oral antineoplastic agents in cancer management, patients and family members need to understand of how to obtain, safely handle, and store the medication, how and when the medications should be taken, and when to report toxic side effects to accomplish efficacious treatment.

DATA SOURCES: Research based articles and conference presentations.

CONCLUSION: Cancer centers to modify policies, protocols, or practices to assure safe and proper administration of oral antineoplastic agents.

IMPLICATIONS FOR NURSING PRACTICE: Clinicians need to monitor and facilitate administration of oral antineoplastic agents, and ultimately improve clinical outcomes.

A Pilot Study Of An Automated Voice Response System And Nursing Intervention To Monitor Adherence To Oral Chemotherapy Agents, Veronica Decker, Sandra L. Spoelstra, Emily Miezo, Renee Bremer, Mei You, Charles W. Given, Barbara A. Given

Peer Reviewed Articles

This study was designed to develop and test a system to monitor adherence with non-hormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants received the Symptom Management Toolkit then participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of < 100% of prescribed oral agents or symptoms of 4 or greater (0-10 scale) for three consecutive weeks, were called by a nurse for assistance with symptom management and adherence to oral chemotherapy medications. Following the 8 weekly AVR calls, patients participated in a follow up interview and medical record review. Subjects were 30 oncology patients who were ambulatory and treated at two cancer centers in Midwest USA. The results indicate 23.3% non adherence rate to oral chemotherapy medications due to symptoms and forgetting to take the medication. An association between symptom management and adherence was found. Symptom severity and beliefs about medications were not significantly different between adherent and non adherent patients. This pilot study demonstrated the ability to accrue patients for a longitudinal trial and informed intervention design, while providing guidance for future interventions and research studies.

This study was designed to develop and test a system to monitor adherence with nonhormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants were patients …