title: A review on adherence management in patients on oral cancer therapies.
abstract: OBJECTIVE
  There is currently an ongoing paradigm shift in cancer treatment from intravenous (IV) chemotherapeutics to oral therapies. Additionally, the increased use of long-term maintenance therapy with oral targeted agents or chemotherapy is contributing to a shift toward a chronic-disease model. This shift is creating challenges and responsibilities for health care professionals in patient adherence management. This article will inform health care professionals of current trends and describe ways that they can overcome common barriers to adherence. A comprehensive review of recommendations and evidence derived from oncological studies describing adherence to oral targeted therapies and maintenance chemotherapy will provide guidance for the use of emerging oral maintenance therapies.
  
  
  METHODS
  Articles in the scientific literature were reviewed if published between January 1985 and November 2010. Searches were conducted using the PubMed database-search terms included "oral therapy," "chemotherapy," "cancer," and "adherence" or "compliance."
  
  
  RESULTS
  The change from IV therapy administered and monitored in hospitals or clinics to self-administered outpatient oral treatments decreases the likelihood of adherence. Methods, such as patient education and monitoring and involvement of family or caretakers, can improve adherence in patients undergoing treatment.
  
  
  CONCLUSIONS
  At treatment onset, oncology nurses can engage patients directly in a collaborative dialogue, and when issues affecting adherence arise, oncology nurses may limit nonadherence by providing individually tailored educational material. A practical approach to patient education, along with building strong health care provider-patient relationships, can help patients overcome nonadherence to new oral anticancer therapies and treatment paradigms.
authors: Department of Clinical Investigations, Institute for Drug Development, Cancer Therapy and Research Center at The University of Texas Health Science Center, Mail Code 8229, 7979 Wurzbach Road, Suite Z413, San Antonio, TX 78229, United States. woodl3@uthscsa.edu
authors: Leslie
authors: L
authors: Wood
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D009062:Mouth Neoplasms / Q000188:drug therapy*; D016903:Drug Monitoring
chemical_list: D000970:Antineoplastic Agents