A clinical practice guideline from the Oncology Nursing Society (ONS) advocates for the use of patient support programs in the setting of oral anticancer medications (OAMs). These guidelines were published in Oncology Nursing Forum.

The treatment landscape for patients with cancer has shifted since the introduction of OAMs, in which up to half of patients now receive oral drugs. This shift from distributing medications in a controlled clinical setting to patient self-management at home has opened the possibility that some patients may have poor treatment adherence.

To best ensure adequate OAM compliance, the guideline authors recommended that patients undergo an adherence risk assessment prior to starting a new OAM with ongoing adherence assessments throughout treatment. On the basis of the risk assessment, a tailored OAM intervention should be designed to help improve treatment adherence.


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For patients who are at risk for noncompliance, the guideline authors suggested that proactive adherence follow-up may be needed. Clinicians should also educate their patients about the importance of medication compliance and advocate for the use of coaching and motivational interviewing.

These interventions may be delivered using a structured OAM program. Such a program may include home visits, patient education, and monitoring for adherence or for drug-related toxicity.

These recommendations were based on low or very low certainty evidence, indicating that additional study of OAM adherence and potential interventions for improving treatment compliance are needed.

The guideline authors concluded, “The recommendations within this clinical practice guideline serve as a first step toward developing a framework for clinicians to support patients who are receiving an OAM treatment regimen. Recommendations encompass the full trajectory of treatment, from initial risk assessment to ongoing monitoring and follow-up, and are intended for all patients with cancer receiving any OAM.”

Reference

Belcher SM, Mackler E, Muluneh B, et al. ONS Guidelines™ to support patient adherence to oral anticancer medications. Oncol Nurs Forum. 2022;49(4):279-295. doi:10.1188/22.ONF.279-295