The Challenges of Oral Agents as Antineoplastic Treatments

Given, Barbara; Spoelstra, Sandra L.; Grant, Marcia

doi:10.1016/j.soncn.2011.02.003

Cited by 86 publications

(67 citation statements)

References 93 publications

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“…Recent progress in treatment of cancer has accelerated an expansion of the development of oral anticancer agents [1]. The availability of oral anticancer agents has a major impact on cancer care.…”

Section: Introductionmentioning

confidence: 99%

“…Optimal adherence is achieved “if no doses are missed, no extra doses are taken, and no doses are taken in the wrong quantity or at the wrong time” [10]. In general, a patient is considered to be adherent if he or she has taken 80% of a prescribed medication [1]. …”

Section: Introductionmentioning

confidence: 99%

“…However, multidisciplinary and multimodal strategies are considered as effective [1]. Also, the literature places a primary emphasis on patient education [4,8,14,15].…”

Section: Introductionmentioning

confidence: 99%

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Current nursing practice for patients on oral chemotherapy: a multicenter survey in Japan

2014

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BackgroundWith a paradigm shift toward a chronic care model in cancer, the issue of adherence is becoming increasingly important in oncology.MethodsWe mailed two self-reported surveys on current nursing practices for patients on oral chemotherapy to all 309 designated cancer centers and 141 large general hospitals in Japan. The first survey was based on a nurse-based questionnaire containing 40 items concerning nurse’s characteristics, nurse staffing at workplace, general nursing care for new patients on oral chemotherapy and those with refilled prescriptions, follow-up, and system-based approach. The second survey was based on a patient-based questionnaire containing 10 items about patient characteristics and adherence-related nursing practice for 249 patients taking oral chemotherapy of 903 systematically sampled. We used multivariate logistic regression to identify factors that were associated with adherence-related nursing practices.ResultsA total of 62 nurses (mean age: 41.5 years) from 62 hospitals who consented participated in the both nurse-based survey and patient-based survey about 249 patients. The results of nurse-based survey indicated that practices varied, but nurses were less likely to ask adherence-related questions of patients with refilled prescriptions than of new patients. The results of patient-based survey found that questions on side effects, discussions about barriers to achieving balance between treatment and daily life activities, and medication management were all significantly related to the question about unused medicines. Logistic regression revealed that adherence-related nursing practices were associated with the nurse’s background, type of treatment, and healthcare system-related factors. Patient orientation on oral chemotherapy, interdisciplinary learning, and having a system-based approach for detecting prescription errors were identified as healthcare system-related factors.ConclusionsA more systematic approach must be developed to ensure patients receive safe and effective oral chemotherapy, while nurses should play significant roles in patient education and monitoring.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current nursing practice for patients on oral chemotherapy: a multicenter survey in Japan

2014

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“…19 Given and colleagues elucidated almost the same issues, adding outcome expectations, health literacy, disease type and stage, and out-of-pocket costs. 28 Moore and Winklejohn discussed factors such as patient history, motivation and relationship with the healthcare provider as important in promoting adherence. When stressing the importance of individualised patient education, these authors recommended the MOATT as a resource.…”

Section: Discussionmentioning

confidence: 99%

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

Rittenberg¹

2012

European Oncology &Amp; Haematology

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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.

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“…With the increasing use of oral agents in cancer treatment (Given, Spoelstra, & Grant, 2011), responsibility for the delivery of treatment has shifted to patients who must rely on themselves and their support systems to accomplish basic aspects of cancer care (e.g., some adverse events management, treatment adherence, drug storage, drug handling, drug administration) between clinic visits. The role of self-care in the management of cancer is pronounced with CML because the standard of care is continuous dosing of TKI therapy for an indefinite period of time.…”

Section: Empowerment and The Patient Role In Managing Chronic Myeloidmentioning

confidence: 99%

Patient Empowerment in the Management of Chronic Myeloid Leukemia

Coleman¹

2014

Clinical Journal of Oncology Nursing

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Patient empowerment is a patient-centered approach to care in which healthcare providers nurture patients' innate abilities to self-manage and incorporate patient goals for therapy into the overall management plan. Standard care of chronic myeloid leukemia (CML) requires lifelong medication with oral therapy and regular follow-up. The success of CML treatment, therefore, depends on a high degree of patient involvement and motivation, as well as strong collaboration between patients and healthcare providers. Oncology nurses can support patients with CML from the time of diagnosis to the end of treatment to ensure they maintain high levels of involvement in their care. At the author's center, patients who most actively collaborate with their physicians in treatment decisions take personal responsibility for the quality of their care and show good adherence to treatment. In the current article, the author discusses the potential effect of patient response to cancer diagnosis on clinical outlook and describes strategies in place at the cancer center to ensure that patients diagnosed with CML have the best chance at keeping their cancer under control.

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The Challenges of Oral Agents as Antineoplastic Treatments

Cited by 86 publications

References 93 publications

Current nursing practice for patients on oral chemotherapy: a multicenter survey in Japan

Current nursing practice for patients on oral chemotherapy: a multicenter survey in Japan

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

Patient Empowerment in the Management of Chronic Myeloid Leukemia

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