title: A pilot study of an automated voice response system and nursing intervention to monitor adherence to oral chemotherapy agents.
abstract: 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 diagnosed with solid tumor cancers, primarily breast, colon, and lung cancers, who received the Symptom Management Toolkit and 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 below 100% of the prescribed oral agents or symptoms of 4 or greater (0-10 scale) for 3 consecutive weeks were called by a nurse for assistance with symptom management and adherence to oral chemotherapy medications. After the 8 weekly AVR calls, patients participated in a follow-up interview and medical record review. Participants were 30 oncology patients who were ambulatory and treated at 2 cancer centers in Midwest United States. The results indicate 23.3% nonadherence 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 nonadherent 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.
authors.affiliation: Cancer Care Associates, Royal Oak, Michigan 48073, USA. vdecker@ccapc.com
authors.forename: Veronica
authors.initials: V
authors.lastname: Decker
authors.forename: Sandra
authors.initials: S
authors.lastname: Spoelstra
authors.forename: Emily
authors.initials: E
authors.lastname: Miezo
authors.forename: Renee
authors.initials: R
authors.lastname: Bremer
authors.forename: Mei
authors.initials: M
authors.lastname: You
authors.forename: Charles
authors.initials: C
authors.lastname: Given
authors.forename: Barbara
authors.initials: B
authors.lastname: Given
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001331:Automation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D054539:Medication Therapy Management; D008991:Monitoring, Physiologic / Q000379:methods*; D009369:Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D015399:Nursing Research; D009859:Oncology Nursing / Q000379:methods; D010349:Patient Compliance / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010865:Pilot Projects; D017010:Reminder Systems; D011795:Surveys and Questionnaires; D013689:Telephone / Q000706:statistics & numerical data; D016903:Drug Monitoring
chemical_list: D000970:Antineoplastic Agents