This article reviews nursing interventions to increase adherence to oral cancer therapies, such as patient and care-partner education, side-effect and medication management, and safety issues. Data sources included peer-reviewed nursing and medical literature, healthcare Web sites, and published monographs. Oncology nurses are uniquely positioned to promote patient adherence to oral cancer therapies by ensuring that patients understand the goals of treatment, promoting safe prescriptive practices, proactively managing treatment side effects, and identifying and resolving underlying barriers to adherence. When adherence is optimized, clinical outcomes are greatly improved. Primary responsibility for adherence to an oral cancer therapy regimen remains with the patient. Oncology nurses, as part of a healthcare team, can have a significant influence on patient adherence by providing thorough and timely patient and family education and by monitoring and managing side effects of treatment. Monitoring adherence to oral cancer therapies is not a recent phenomenon nor limited to oral cancer treatments but presents an increasing challenge as additional oral therapies enter the marketplace. Oncology nurses should develop and enhance strategies and materials for patient education on oral cancer therapies, improve side-effect management, assist with patient access to medications, and develop practice guidelines to ensure adherence and promote safety.

Since 2005, many oral chemotherapy agents have been released. Nurses often are not directly involved with patients who receive oral agents. Difficulties with adherence, safety, patient teaching, and access to oral agents can hinder treatment. Nurses can increase adherence and keep patients safe by developing standardized written prescriptions, encouraging the use of patient diaries, offering dosage calendars, and supplying contact information for an office pharmacist.

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Carboplatin is used widely to treat cancers such as lung, breast, and ovarian. Hypersensitivity reactions (HSRs) to carboplatin can occur, often after numerous doses. The reactions can range from mild to life threatening. Oncology nurses witness the reactions and are instrumental in providing interventions to assist patients. Symptoms include flushing, rashes, itchy palms, nausea, difficulty breathing, back pain, hypotension, and tachycardia. Interventions include support of patients with oxygen and IV hydration along with administration of certain medications to diffuse HSRs. Predictive measures may include skin testing on patients who have received more than seven total doses of carboplatin, Desensitization protocols may be useful for patients with positive skin tests. Ultimately, with the potential for life-threatening reactions, patients and physicians need to consider the risk-to-benefit ratio of using the drug.