Adherence to oral chemotherapy regimens maximizes their effectiveness and minimizes any potential toxicities. Factors specifically related to the treatment, patient, and health care provider may influence medication adherence. Treatment‐related factors include the complexity of the regimen, the cost of therapy, the possibility of side effects, and the delay in treatment benefits. Meanwhile, patients may not have an adequate support system or an understanding of the need for the medication, and providers may not fully succeed in communicating the importance of adherence and the types of side effects that may occur. Nonadherence may lead to an increased risk of toxicity, decreased effectiveness, and increased utilization of health care resources. Although various methods for measuring adherence are available, self‐reporting is the most widely used. Studies describing adherence in a broad range of cancers are reviewed. Treatment of chronic myeloid leukemia has been revolutionized by the development of oral tyrosine kinase inhibitors that are highly effective in managing the disease when taken consistently. However, nonadherence is relatively common and can lead to reduced rates of response and increased medical costs. Similar effects of nonadherence on outcome and cost have also been observed in patients with various other hematologic malignancies and solid tumors. Interventions to improve adherence to oral chemotherapy regimens include communication about the importance of adherence and the potential consequences of nonadherence, simplification of the patient's medication schedule (if possible), and inclusion of a caregiver or family member in the conversation. Written materials should always be provided to accompany verbal instructions. This review summarizes factors influencing medication adherence, impact of nonadherence on patient outcomes, methods for measuring adherence, previous studies of nonadherence in patients with cancer, common barriers to access, and interventions to improve adherence in the community setting.

Drug-induced agranulocytosis is a severe complication that has been implicated with most classes of medications. Medications such as clozapine, trimethoprim-sulfamethoxazole and methimazole have been more commonly associated with agranulocytosis than other agents. Although the pathogenesis isn't fully elucidated, it appears to be two-fold with a direct toxicity to the myeloid cell line and immune-mediated destruction. Patients may be asymptomatic at the time neutropenia is discovered or may present with more severe complications such as sepsis. In approximately 5% of cases drug-induced agranulocytosis may be fatal. Management of drug-induced agranulocytosis includes the immediate discontinuation of the offending medication, initiation of broad-spectrum antibiotics and consideration of the use of granulocyte colony-stimulating factors in high-risk patients.

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Objective. To describe the development, implementation, and assessment of simulated interprofessional education (IPE) telehealth case activities. Methods. Faculty from pharmacy and physician assistant schools developed interprofessional cases covering topics addressed in both curricula and designed for specific levels of learners. Using a telehealth format, pharmacy students were paired with physician assistant students and met at specified times in a virtual room. Faculty representing both professions assessed students as they discussed a patient case, determined a diagnosis, and collaborated to develop appropriate treatment options. Preexperience and post-experience data and student reflections were collected. Results. Pharmacy students' responses to items on the Team Skills Scale (TSS) completed after participating in four IPE telehealth case activities indicated positive changes. Mean total TSS scores significantly improved from pre-experience 62.3 (SD 8.4) to post-experience 72.6 (SD 5.7). Quantitative evaluation of student teams' participation in an interprofessional activity was assessed using the Creighton Interprofessional Collaborative Evaluation (C-ICE) instrument and the average score was 90%. Theme analysis was performed on student reflections and the most prominent themes identified were satisfaction from interacting with other health care professionals, increased confidence in clinical decision-making ability, and affirmation that IPE telehealth cases should be included in each year of the curriculum. Conclusion. Implementation of interprofessional cases using telehealth technology is an effective way for pharmacy schools to incorporate IPE into their curriculum. Students reported improved self-perception of interprofessional competence and attitudes toward interprofessional collaboration after participating in IPE telehealth cases.

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