A Pilot Study to Test Interventions to Improve Adherence and Symptoms from Oral Agent(s)Oncology Nursing Society (2009)
Significance: This pilot study makes important contributions to the new ONS research agenda priority by promoting and managing treatment adherence. If management of symptoms is shown to improve adherence to oral cancer mediations, this will link two concerns among oncology nurses, patient adherence to medication protocol and symptom management.
Problem & purpose: The purpose of this study was to assess the feasibility of accruing cancer patients who are undergoing treatment using oral chemotherapy to actively participate in a research project and to test an Automated Voice Response (AVR) system complemented by nurse strategies for more severe symptoms, to improve adherence to oral chemotherapy. The strategies utilized in the pilot explored a study design to link improved symptom management with greater adherence enabling investigators to establish effect and sample size, and to inform research questions for an intervention trial.
Theoretical/scientific framework: This scientific method utilized a modified health belief model approach to patient adherence to build upon a cognitive behavioral intervention framework for symptom management.
Methods & analysis: Participants received the Symptom Management Toolkit® then participated in an Interview for symptom severity, satisfaction, and belief about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of < 80% of prescribed oral agents or symptoms of 4 or greater (0-10 scale) for three consecutive weeks, were called by a nurse for symptom management and adherence to oral chemotherapy medications. Following the 8 weekly AVR calls patients participated in a follow up Interview and medical record review.
Findings & implications: This pilot study included31 patients from two Cancer Centers in the Midwest. Findings indicate a 22.6% non adherence rate to oral chemotherapy medications with half of the non adherence due to symptoms. Findings indicate symptom severity was not significantly different between adherent and non adherent patients. This pilot study demonstrated the ability to accrue patients for a longitudinal trial and informed intervention design. Adherence with oral agents is becoming a major area of concern for health professionals caring for cancer patients. This pilot provides some guidance for future interventions and research studies.
Publication DateSpring 2009
Citation InformationSandra Spoelstra. "A Pilot Study to Test Interventions to Improve Adherence and Symptoms from Oral Agent(s)" Oncology Nursing Society (2009)
Available at: http://works.bepress.com/sandra-spoelstra/19/