As cancer treatment in pill form transforms how care is delivered, a new study underscores the challenges faced by patients in administering their own chemotherapy outside the supervised environment of a cancer clinic. Although chemotherapy pills can target specific cancers better than some traditional intravenous drugs, they can also be difficult for patients to take.

“Prescriptions for some oral pills have complex instructions,” said Sandra Spoelstra, PhD, RN, of Michigan State University College of Nursing. “Some of them require patients to take pills several times a day or cycle their doses, taking one pill a day for 3 weeks, then stopping for a week before starting again. And some patients take two types of pills to treat their cancer or have multiple medications for other chronic conditions. It can be very complicated.”

Further, such side effects as severe nausea, vomiting, diarrhea, fatigue, skin reaction, and pain are common. Those symptoms can lead some patients to skip doses, which may render their cancer treatment ineffective.

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In this study, patients were randomly assigned to one of three groups. The first group only had help from an automated calling system to see if they were following their prescriptions and to help them monitor and manage symptoms. The second group had the automated calls and follow-up calls from nurses with strategies to help them stick with their pill regimen. The third group had automated calls and nurse advice on both adhering to their regimen and on managing symptoms.

At the end of the study, patients in all three groups reported less severe symptoms. The automated calls were just as effective alone as when they were coupled with nurse guidance. Spoelstra explained that this suggests that the automated system could be a simple and inexpensive way to help some patients take their drugs properly.

This study was published in Cancer Nursing (2013;36[1]:18-28).