title: Oral Anticancer Medication Adherence, Toxicity Reporting, and Counseling: A Study Comparing Health Care Providers and Patients.
abstract: OBJECTIVE
  Oral anticancer medications (OACMs) have created new treatment opportunities, but also challenges for patients and practitioners. We aimed to compare health care provider (HCP) and patient perceptions on OACM adherence, toxicity reporting, and patient educational needs.
  
  
  METHODS
  An online survey for HCPs and paper survey for patients were analyzed using descriptive statistics. Bivariate analysis using the χ(2) test was used for some questions.
  
  
  RESULTS
  There were 169 HCP and 143 patient responses; 91% of patients reported taking their OACMs as prescribed more than 75% of the time, but only 40% of HCPs believed their patients were as adherent; 97% of HCPs believed patients reported their adverse effects some or most of the time; 61% of patients reported toxicities sometimes, often, or very often, but 30% never or rarely reported; 66% of HCPs believed patients did not report toxicity because of fear of treatment interruption, compared with 2% of patients. HCPs (53%) and patients (62%) both believed adverse effect tolerance was a common reason not to report. Most HCPs (70%) believed patients reported adverse effects first to a nurse. Patients seemed to report equally to nurses (42%) and oncologists (38%). Both HCPs and patients favored paper-based educational materials and call-back programs.
  
  
  CONCLUSIONS
  This study highlights disparities in patient and HCP perceptions of OACM adherence principles and toxicity reporting. Opportunities for improved patient education are identified, particularly around reporting significant toxicities. Different HCPs may benefit from complimentary counseling tools to encompass the entire spectrum of patient needs and provider practice.
authors.affiliation: Sunnybrook Odette Cancer Centre; and University of Toronto, Toronto, Ontario, Canada sonal.gandhi@sunnybrook.ca.
authors.forename: Sonal
authors.initials: S
authors.lastname: Gandhi
authors.affiliation: Sunnybrook Odette Cancer Centre; and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Larissa
authors.initials: L
authors.lastname: Day
authors.affiliation: Sunnybrook Odette Cancer Centre; and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Thivaher
authors.initials: T
authors.lastname: Paramsothy
authors.affiliation: Sunnybrook Odette Cancer Centre; and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Angie
authors.initials: A
authors.lastname: Giotis
authors.affiliation: Sunnybrook Odette Cancer Centre; and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Maggie
authors.initials: M
authors.lastname: Ford
authors.affiliation: Sunnybrook Odette Cancer Centre; and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Boudreau
authors.affiliation: Sunnybrook Odette Cancer Centre; and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Pasetka
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000706:statistics & numerical data*; D010465:Perception; D010818:Practice Patterns, Physicians'; D016903:Drug Monitoring
chemical_list: D000970:Antineoplastic Agents