ONS PEP Putting Evidence Into Practice: Evidence-Based Interventions for Oral Anti-Cancer AgentsOncology Nursing Society (2015)
Significance: Adherence to oral anti-cancer agents is a significant clinical problem among patients who are very sick with a life threatening disease and may have a substantial impact on treatment success or failure.
Problem & Purpose: The limited evidence available suggests that adherence to oral anti-cancer agents is a significant clinical problem and may have a substantial impact on treatment success or failure. The purpose of this paper is to report on the Oncology Nursing Society (ONS) Putting Evidence Into Practice (PEP) initiative, a comprehensive examination of the current literature was conducted to identify effective interventions for patients prescribed oral anti-cancer agents.
Framework: Not applicable.
Methods: The ONS PEP Weight of Evidence Classification Schema levels of evidence were used to categorize interventions to assist nurses in identifying strategies that are effective at improving adherence. An extensive review of the literature regarding medication adherence was conducted using MEDLINE, the National Library of Medicine database, CINAHL, and the Cochrane Database using the consolidated problem, intervention, comparison and outcome (PICO) terms. Articles were in the past 10 years, in English, and in adults (>18 years of age). The PEP team used a systematic approach to review, critique, and assign levels of evidence.
Findings: A total of 120 studies met the inclusion criteria and were included in the review. Patient feedback and monitoring and multicomponent interventions wererecommended for practice (n=4); text messaging, automated voice response, and treatment of depressive symptoms were likely to be effective (n=22); and education, cognitive behavioral therapy, motivational interviewing, behavioral contracting, packaging, dosing, reminders, medication dispensers, electronic devices, decision aids, calendars, refill cues, system level interventions, health information technology, and copay reduction were effectiveness not found (n=94). No interventions were found that were effectiveness unlikely, benefits balanced with harms, or not recommended for practice.
Implications: The majority of evidence found was conducted in conditions other than cancer, thus, research is needed to identify if these interventions are effective at promoting adherence in cancer patients.
Publication DateSummer 2015
Citation InformationSandra Spoelstra. "ONS PEP Putting Evidence Into Practice: Evidence-Based Interventions for Oral Anti-Cancer Agents" Oncology Nursing Society (2015)
Available at: http://works.bepress.com/sandra-spoelstra/27/