title: An intervention to improve adherence and management of symptoms for patients prescribed oral chemotherapy agents: an exploratory study.
abstract: BACKGROUND
  Use of oral chemotherapy agents to treat cancer has increased. Patients are responsible for adhering to complex regimens while managing symptoms from adverse effects of the chemotherapy.
  
  
  OBJECTIVE
  This study examined an intervention to manage symptoms and adherence to oral agents.
  
  
  METHODS
  A 3-group 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 Toolkit, completed a baseline interview, and were randomized to receive 8 weekly AVR calls. An exit interview occurred at 10 weeks.
  
  
  RESULTS
  Mean age was 59.6 years, with 70% female and 76% white, and 42% were nonadherent, with missed doses increasing with regimen complexity. Symptom severity declined over time in all groups. No difference was found in adherence rates, and higher adherence was related with lower symptom severity across groups.
  
  
  CONCLUSIONS
  Adherence, a significant clinical problem, can affect efficacy of the cancer treatment. The AVR intervention alone was just as effective as the AVR plus the nurse intervention at promoting adherence and managing symptoms from adverse effects.
  
  
  CONCLUSIONS
  Nurses need to focus on patient education by ensuring patient understanding of oral agent regimen and the need to adhere to the oral agent for efficacious cancer treatment. Nurses can promote the use of medication reminders and self-management of symptoms from adverse effects, to support adherence to the oral agent.
authors.affiliation: College of Nursing, Michigan State University, East Lansing, MI 48824, USA. Sandra.Spoelstra@hc.msu.edu
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Spoelstra
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Given
authors.forename: Charles W
authors.initials: CW
authors.lastname: Given
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Alla
authors.initials: A
authors.lastname: Sikorskii
authors.forename: Mei
authors.initials: M
authors.lastname: You
authors.forename: Veronica
authors.initials: V
authors.lastname: Decker
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010865:Pilot Projects; D012720:Severity of Illness Index; D017216:Telemedicine / Q000379:methods*; D016903:Drug Monitoring
chemical_list: D000970:Antineoplastic Agents