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A Pilot Study of an Automated Voice Response System and Nursing Intervention to Monitor Adherence to Oral Chemotherapy Agents
Peer Reviewed Articles
  • Veronica Decker, Cancer Care Associate
  • Sandra L. Spoelstra, Grand Valley State University
  • Emily Miezo, Michigan State University
  • Renee Bremer, Michigan State University
  • Mei You, Michigan State University
  • Charles W. Given, Michigan State University
  • Barbara A. Given, Michigan State University
Publication Date
12-1-2009
Keywords
  • Adherence,
  • Automated Voice,
  • Response,
  • Oral agents
Abstract
This study was designed to develop and test a system to monitor adherence with non-hormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants received the Symptom Management Toolkit then participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of < 100% of prescribed oral agents or symptoms of 4 or greater (0-10 scale) for three consecutive weeks, were called by a nurse for assistance with 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. Subjects were 30 oncology patients who were ambulatory and treated at two cancer centers in Midwest USA. The results indicate 23.3% non adherence rate to oral chemotherapy medications due to symptoms and forgetting to take the medication. An association between symptom management and adherence was found. Symptom severity and beliefs about medications were 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, while providing guidance for future interventions and research studies. This study was designed to develop and test a system to monitor adherence with nonhormonal oral chemotherapeutic agents using an automated voice response (AVR) system plus nursing intervention. Participants were patients diagnosed with solid tumor cancers, primarily breast, colon, and lung cancers, who received the Symptom Management Toolkit and participated in an interview for symptom severity, satisfaction, and beliefs about oral agents. Patients received weekly AVR calls, which assessed adherence to oral agents and severity of 15 symptoms. Patients who reported adherence of below 100% of the prescribed oral agents or symptoms of 4 or greater (0 Y 10 scale) for 3 consecutive weeks were called by a nurse for assistance with symptom management and adherence to oral chemotherapy medications. After the 8 weekly AVR calls, patients participated in a follow-up interview and medical record review. Participants were 30 oncology patients who were ambulatory and treated at 2 cancer centers in Midwest United States. The results indicate 23.3% nonadherence rate to oral chemotherapy medications due to symptoms and forgetting to take the medication. An association between symptom management and adherence was found. Symptom severity and beliefs about medications were not significantly different between adherent and nonadherent patients. This pilot study demonstrated the ability to accrue patients for a longitudinal trial and informed intervention design while providing guidance for future interventions and research studies.
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Original Citation:

Decker, V., Spoelstra, S., Miezo, E., Bremer, R., You, M., Given, C., & Given, B. (2009). A Pilot Study of an Automated Voice Response System and Nursing Intervention to Monitor Adherence to Oral Chemotherapy Agents. Cancer Nursing, 32(6), E20–E29. http://doi.org/10.1097/NCC.0b013e3181b31114
Citation Information
Veronica Decker, Sandra L. Spoelstra, Emily Miezo, Renee Bremer, et al.. "A Pilot Study of an Automated Voice Response System and Nursing Intervention to Monitor Adherence to Oral Chemotherapy Agents" (2009)
Available at: http://works.bepress.com/sandra-spoelstra/36/