131IN - Clinical issues in patients receiving oral tumour therapy: How can we improve adherence?

Date 28 September 2014
Event ESMO 2014
Session ESMO-EONS: Oral tumour therapy: Collaboration and coordination of healthcare professional activities to enhance patient adherence
Topics Supportive measures
Presenter Alfredo Carrato
Citation Annals of Oncology (2014) 25 (suppl_4): iv46-iv47. 10.1093/annonc/mdu320
Authors A. Carrato
  • Medical Oncology Department, RAMON Y CAJAL UNIVERSITY HOSPITAL, 28034 - MADRID/ES

Abstract

Body

Abstract:

When oral cancer therapy is prescribed, an appropriate oncologist-patient and nurse-patient communication is crucial in preserving the quality of cancer care. They must evaluate patients' diet, concomitant medications, provide useful recommendations, a good patient education, an adequate health care access and a well designed therapeutic monitoring plan for improvement of treatment adherence to avoid loss in efficacy or increased risk of toxicity Aspects that could influence on oral drug adherence: - Patient's failure to understand the benefits and risks of the medication - Complexity in the drug intake form and schedule - Long lasting treatments - Difficulties to access to the caregiver - Absence of a follow-up program - The elderly, comorbidities and frailty - Deficient familial or social support - Treatment costs Forms of intervention to enhance medication adherence: - Nurses to schedule an educational appointment with the patient. A call list is made with standardized forms and schedules for phone calls - To be available when needed by the patient. A full time nurse could be devoted to patients on oral treatments - A proper communication with the patient o To improve patient's education o To assure they know the name and schedule of the drugs, and the importance of adherence o To know other medications or pills taken o To check the easiness to swallow oral drugs o To discuss patient's responsibility in her/his health care - Design an efficient system o To audit that the tablets are correctly taken o To provide the patient with technical aides o To give written instructions on how to proceed if a dose is missed or repeated o To know when to call the doctor or nurse o To follow-up periodically, in person, with phone calls or electronically, to monitor how is everything going on - Enhance empathy and patient's motivation, support patient's self esteem and empowerment - Identify financial problems, that could interfere with adherence We cannot rely on a visit to the hospital to ensure that oral anticancer treatment is properly taken. We need to pay much more attention to adherence, and develop different forms of intervention to make an optimal use of cancer innovation at the patients' home.

Disclosure:

The author has declared no conflicts of interest.