Adherence to Oral Cancer Therapies

Abstract

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.

Adesão De Pacientes Ao Tratamento Com Antineoplásicos Orais: Fatores Influentes

“…Presume-se que o fornecimento de informações orais e escritas, que incluam os objetivos do tratamento, a importância do seguimento da prescrição medicamentosa e os efeitos colaterais mais comuns, garanta a continuidade, evite a não aderência e, consequentemente, melhore os efeitos da terapia medicamentosa (8) .…”

“…No que tange ao tratamento no caso de doenças crônicas, os cuidados são, em sua maioria, responsabilidade do indivíduo e de cuidadores, sendo necessário, além do cumprimento das orientações médicas, entender, concordar e adotar o tratamento prescrito (8) . Não existe um consenso padrão, que determina qual seja a taxa ideal de adesão para antineoplásicos orais, entretanto valor acima de 90% é considerado adequado, de acordo com um ensaio clí-nico desenvolvido para observar quais seriam as respostas moleculares completas (6) .…”

“…Ainda nesse âmbito, a equipe de enfermagem tem papel fundamental como educadora junto a pacientes e familiares (8) . A comunicação é a principal forma de iniciar um relacionamento para que se possa compreender e aderir ao tratamento.…”

Adherence and awareness of the therapeutic intent of oral anticancer agents in an outpatient setting

“…Cancer chemotherapy can be administered as oral single agents, injected single agents, or a combination of oral and injected agents (12)(13)(14). Cancer treatment with oral anticancer agents has the advantage of ease of delivery, however, as medication management is the responsibility of the family or patient, medication adherence can be a problem.…”

Key Element in Oral Chemotherapy: Patient Adherence

“…Ayrıca bazı oral kemoterapi kombinasyonları da tedaviyi daha karmaşık hale getirebilir. Bu nedenle ilaç kullanım planının iyi açıklanması hasta ve sağlık personeli için daha sonraki süreçlerin kolaylaşmasını sağlar (7,8). Uyumu İzleme Uyumun izlenmesi direkt ve indirekt olmak üzere iki şekilde ele alınmaktadır.…”