Medicine and Health Sciences Commons^™

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

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

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.

Testing The Differential Effects Of Symptom Management Interventions In Cancer, Alla Sikorskii, Charles W. Given, Azfar-E-Alam Siddiqi, Victoria Champion, Ruth Mccorkle, Sandra L. Spoelstra, Barbara A. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Objective: The purpose of this study was to test for moderating effects of patient characteristics on self-management interventions developed to address symptoms during cancer treatment. Patient’s age, education and depressive symptomatology were considered as potential moderators. Methods: A secondary analysis of data of 782 patients from two randomized clinical trials was performed. Both trials enrolled patients with solid tumors undergoing chemotherapy. After completing baseline interviews, patients were randomized to a nurse-delivered intervention versus intervention delivered by a “coach” in trial I, and to a nurse-delivered intervention versus an intervention delivered by an automated voice response system in trial II. In …

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

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

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

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

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, …

A Randomized Controlled Trial Of The Feasibility And Preliminary Efficacy Of A Texting Intervention On Medication Adherence In Adults Prescribed Oral Anti-Cancer Agents: Study Protocol, Sandra L. Spoelstra, Charles W. Given, Alla Sikorskii, Constantinos K. Coursaris, Atreyee Majumder, Tracy Dekoekkoek, Monica Schueller, Barbara A. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Aim: The aim of this study was to report a study protocol that examines feasibility, preliminary efficacy and satisfaction of a text message intervention on the outcome of medication adherence in adult patients prescribed oral anti-cancer agents. Background: Administration of oral anti-cancer agents occurs in the home setting, requiring patients to self-manage the regimen as prescribed. However, many barriers to medication adherence exist: regimens are often complex, with cycling of two or more medications; side effects of treatment; most cancer patients are older with comorbid conditions and competing demands; and cognitive decline and forgetfulness may occur. Research indicates patients miss …

A Trial Examining An Advanced Practice Nurse Intervention To Promote Medication Adherence And Symptom Management In Adult Cancer Patients Prescribed Oral Anti-Cancer Agents: Study Protocol, Sandra L. Spoelstra, Peggy S. Burhenn, Tracy Dekoekkoek, Monica Schueller

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Aim: To report a study protocol that refines then examines feasibility, preliminary efficacy, and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behavioral therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents. Background: Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centers to patients and their caregivers. Thus, a need exists to standardize start-of-care for support patient self-management of care at home. Design: A two-phase quasi-experimental sequential design with repeated measures. Methods: Sixty five adult patients …

Acceptability And Preliminary Efficacy Of A Sms Text Message Intervention In Older Cancer Patients, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

An Intervention To Improve Adherence And Symptoms For Oral Oncolytics, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Feasibility Of Text Messaging To Improve Oral Anti-Cancer Adherence In Older Cancer Patients, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Falls, Fall Sequale, And Healthcare In Aging Community Dwelling Elderly Cancer Survivors, Sandra Spoelstra

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN