Meeting Educational Needs and Enhancing Adherence of Patients Receiving Oral Cancer Agents Through Use of the MASCC Oral Agent Teaching Tool©

Abstract

The challenge of patient education traditionally is a responsibility of nurses. The nursing process of assessing, planning, implementing and evaluating is never more appropriate than when teaching patients and families about cancer treatments. In the past, as patients prepared for traditional IV (intravenous) treatment, nurses had a 'captured audience' to teach and the opportunity to then reinforce repeated verbal instructions and written materials, slowly and thoroughly reviewing procedures and potential problems. Plus, nurses had ample opportunities to physically see and touch patients throughout the course of their treatments in order to assess for treatment side effects and disease symptoms. However, today, patients prescribed oral chemotherapy may never see a nurse. The physician may write a prescription, which is then filled by a pharmacist. AbstractJust as new discoveries are changing the approach to 'personalise' cancer treatments, the medications to treat cancers have changed as well. Anticancer agents now include cytotoxics, thought of as traditional chemotherapy, and biologics, often referred to as targeted therapy, many of which are formulated as oral agents. This changing model has resulted in new challenges for oncology professionals to ensure that patients receive education in a comprehensive and consistent manner regarding oral agents. In response to published reports and studies citing the adherence and safety problems for people on these oral medications, along with the noted lack of systematic teaching strategies, the MASCC Oral Agent Teaching Tool © (MOATT), issued by the Multinational Association of Supportive Care in Cancer (MASCC), was designed by oncology nurses to meet the need for a complete and dependable approach to education.

Chemotherapy e-prescribing: opportunities and challenges

“… 22 Additionally, 20%–30% of chemotherapy agents in the development pipeline will be administered orally. 23 Recent studies of the oral chemotherapy medication use process identified key vulnerabilities, including patient education about drug handling and adverse effects, prescription writing, monitoring, and toxicity management, and highlighted the need to adopt rigorous safety standards. 24 – 26 However, adoption of these practice standards has been lagging for the oral chemotherapy agents.…”

A Structured Nursing Intervention to Address Oral Chemotherapy Adherence in Patients With Non-Small Cell Lung Cancer

“…Prior publications (Kav et al, 2010;Rittenberg, 2012) have promoted the MOATT as standard-of-care education, but randomized trials have yet to be published regarding the tool's efficacy. Additional testing of innovative multimethod strategies, including nurse-led instruction, medication prompting, and reinforcement, with monitoring of self-care behaviors and symptoms, has been recommended to increase medication adherence (Schneider, 2012;Schneider, Hess, & Gosselin, 2011;Weingart et al, 2012), improve management of symptoms (Moody & Jackowski, 2010), and optimize patient outcomes.…”

A smartphone program to support adherence to oral chemotherapy in people with cancer: Proof‐of‐concept trial

“…The strategy “information about oral chemotherapy” consisted of five individual documents containing information extracted from the Australian website (eviQ.org.au), which is routinely used by Australian cancer institutions, and based on guidelines from the Multinational Association of Supportive Care in Cancer Oral Agent Teaching Tool (MOATT) 23 . Documents on how to manage the main five side‐effects from each OC in the study (in the product information) were based on the Symptom Management Toolkit, 24 with permission from the Michigan State University adapted to the Australian context by the researcher oncologist (IO) 22…”