Guideline Supports Patient Adherence to Oral Anticancer Medications

By Leah Lawrence - Last Updated: October 5, 2022

A recently published clinical guideline offers suggested recommendations to support patient adherence to oral anticancer medications (OAM).

According to the guidelines, published in Oncology Nursing Forum, the treatment landscape for patients with cancer has shifted in recent years, with OAMs accounting for 40% to 50% of new cancer treatments in development.

“Shifting treatment from a controlled clinical setting to a patient’s home has advantages, paired with potential challenges for the patient and health care team,” guideline authors wrote. “Nurses and pharmacists are uniquely positioned to support optimal adherence in patients with cancer. Using evidence-based interventions to inform best practices for supporting patients taking OAMs is important.”

These guidelines were developed to help address this growing need.

The first recommendation suggested an adherence risk assessment in addition to usual care rather than usual care alone for patients starting a new OAM. Additionally, the guideline panel suggested education addressing adherence in addition to standard education, rather than standard education alone.

“Although the panel acknowledged that some degree of risk assessment is already being used in clinical settings, and acceptability of this intervention may not present a challenge, feasibility considerations should be investigated further (e.g., the capacity to process, triage, and utilize results of these assessments),” the authors wrote.

In addition to this initial assessment, ongoing assessment of adherence is also recommended. Patients with additional risk factors for nonadherence should receive proactive follow-up addressing adherence. These patients may also benefit from coaching or motivational interviewing. Coaching and motivational interviewing, the panel wrote, may improve adherence rates and medication-possession ratio in patients with cancer. Motivational interviewing can also improve patient self-efficacy about their treatment.

The panel made no recommendation for the use of technology, either interactive or noninteractive, based on a knowledge gap. However, it did recommend implementation of a structured OAM program.

All of these recommendations were conditional and based on very low or low quality of evidence.

“The recommendations within this clinical practice guideline serve as a first step toward developing a framework for clinicians to support patients who are receiving an OAM treatment regimen,” the authors wrote. “In the future, research may identify specific interventions that are targeted to specific patients or specific regimens. Research is also needed on patient and system factors that are related to adherence, such as financial toxicity.”

 

Reference

ONS Guidelines ™ to Support Patient Adherence to Oral Anticancer Medications

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