title: A trial examining an advanced practice nurse intervention to promote medication adherence and symptom management in adult cancer patients prescribed oral anti-cancer agents: study protocol.
abstract: OBJECTIVE
  To report a study protocol that refines then examines feasibility, preliminary efficacy and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behaviorial therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents.
  
  
  BACKGROUND
  Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centres to patients and their caregivers. Thus, a need exists to standardize start-of-care to support patient self-management of care at home.
  
  
  METHODS
  A two-phase quasi-experimental sequential design with repeated measures.
  
  
  METHODS
  Sixty-five adult patients newly prescribed an oral anti-cancer agent will be recruited from three community cancer centres. Phase 1 will enrol five patients to refine the ADHERE intervention prior to testing. After completion, Phase 2 will enrol 30 patients who receive usual care. Advanced practice nurses will then be trained. Thirty patients will be then enrolled in the intervention group and provided ADHERE, a 4-week intervention using semi-structured interactions (initial face-to-face session and once a week phone sessions over 3 weeks) and a Toolkit to promote self-management of care. Outcome measures include: oral anti-cancer agents adherence rate, symptom presence and severity, feasibility and satisfaction with ADHERE. This protocol was approved January 2014.
  
  
  CONCLUSIONS
  This nurse-led intervention has the potential to standardize the start-of-care training for the patients to self-manage when oral anti-cancer agents for treatment were prescribed.
authors.affiliation: Grand Valley State University, Kirkhof College of Nursing, Grand Rapids, Michigan, USA.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Spoelstra
authors.affiliation: City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Peggy S
authors.initials: PS
authors.lastname: Burhenn
authors.affiliation: Michigan State University, College of Nursing, East Lansing, Michigan, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: DeKoekkoek
authors.affiliation: Michigan State University, College of Nursing, East Lansing, Michigan, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Schueller
mesh_terms: D000284:Administration, Oral; D000328:Adult; D057179:Advanced Practice Nursing / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D062405:Motivational Interviewing; D009369:Neoplasms / Q000188:drug therapy*; D009740:Nursing Staff / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D010361:Patients / Q000523:psychology; D015397:Program Evaluation; D012648:Self Care / Q000523:psychology
chemical_list: D000970:Antineoplastic Agents
keywords: advanced practice Registered Nurse; cancer; clinical trial; cognitive behavioural therapy; motivational interviewing; oral anti-cancer agent; patient education; practice-based research