An increasing number of patients benefit from oral anticancer medications, which are less invasive and more convenient. However, a treatment plan that relies on the patient to self-administer their medications means that patients have to understand and learn how to manage what can be a complex regimen at home without any help from a healthcare professional.
A team of nurse researchers conducted a systematic review of published research to explore the efficacy of interventions designed to support these patients and improve their adherence to oral anticancer regimens. The findings were published in Oncology Nursing Forum.
The literature search identified a variety of interventions that were intended to support oral anticancer medication adherence, including counseling, technology, education, follow-up, and structured programs. The 49 full-text studies (with a total of 50,379 patients) included in the researchers’ quantitative synthesis showed that some interventions provide some benefit compared with usual care, but not in all cases.
For example, risk assessment may improve adherence, as could periodic assessment of adherence and active follow-up, but educational programs may have little to no effect on adherence compared with usual care. The same was found to be true for coaching interventions. Other study findings included:
- Technological intervention may improve adherence compared with usual care.
- No difference in adherence was noted between interactive and noninteractive technology.
- Structured medication programs may improve adherence.
- Motivational interviewing may improve adherence.
These findings provide a foundation for future research. They also provide some useful information for oncology nurses. Namely, there are interventions that can be incorporated into patient care that will improve adherence to at-home oral therapy.
“Patients prescribed an [oral anticancer medication] for cancer treatment require support and collaboration from healthcare professionals to ensure optimal treatment adherence,” the researchers concluded. “Although no single intervention proved to be the most clinically relevant, studies demonstrated that multiple interventions are available for use in the care of patients taking [oral anticancer medications] and can be incorporated into clinical practice.”
This study did have some limitations. It only analyzed information from studies published in English. Additionally, the study population was heterogeneous in the type of cancer and oral anticancer medication regimens, and pooled analysis was not always available because of the heterogeneity in how the outcomes were reported.
Waseem H, Ginex PK, Sivakumaran K, et al. Interventions to support adherence to oral anticancer medications: systematic review and meta-analysis. Oncol Nurs Forum. 2022. 49(4), E4-E16. doi:10.1188/22.ONF.E4-E16