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Bandiera C, Skrabal Ross X, Cardoso E, Wagner D, Csajka C, Olver I, Patterson P, Suppiah V, Gunn KM, Schneider M. Interventions to support adherence to oral anticancer therapies: research challenges, lessons learned, and strategies to overcome them from Australia and Switzerland. Support Care Cancer 2022; 30:3655-3659. [PMID: 34993650 DOI: 10.1007/s00520-021-06710-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022]
Abstract
Not monitoring adherence to oral anticancer therapies (OAT) can lead to poor clinical outcomes, including premature death as reported by Foulon et al. (Acta Clin Belg 66(2):85-96, 2011) and Greer et al. (Oncologist 21(3):354-76, 2016). Barriers to the implementation of supportive cancer care interventions in medication adherence occur with multiple hospital sites, cancer diagnoses, and numerous healthcare professionals. This commentary describes challenges and strategies from two OAT adherence trials in Australia and Switzerland to assist researchers in the design and implementation of future interprofessional trials.
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Affiliation(s)
- Carole Bandiera
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Rue Michel Servet 1, 1211, Geneva, Switzerland.
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland.
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
| | - Xiomara Skrabal Ross
- Cancer Research Institute, University of South Australia, Adelaide, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
- Canteen Australia, Research, Evaluation and Social Policy Unit, GPO Box 3821, Sydney, New South Wales, 2001, Australia
| | - Evelina Cardoso
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Dorothea Wagner
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Chantal Csajka
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Rue Michel Servet 1, 1211, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ian Olver
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Pandora Patterson
- Canteen Australia, Research, Evaluation and Social Policy Unit, GPO Box 3821, Sydney, New South Wales, 2001, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Vijayaprakash Suppiah
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- Australian Centre for Precision Health, University of South Australia, Adelaide, Australia
| | - Kate M Gunn
- Department of Rural Health, University of South Australia, Adelaide, Australia
| | - Marie Schneider
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Rue Michel Servet 1, 1211, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
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Sikorskii A, Given CW, Given BA, Vachon E, Krauss JC, Rosenzweig M, McCorkle R, Champion VL, Banik A, Majumder A. An Automated Intervention Did Not Improve Adherence to Oral Oncolytic Agents While Managing Symptoms: Results From a Two-Arm Randomized Controlled Trial. J Pain Symptom Manage 2018; 56:727-735. [PMID: 30096441 PMCID: PMC7646373 DOI: 10.1016/j.jpainsymman.2018.07.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 01/28/2023]
Abstract
CONTEXT An increasing number of oral cancer treatments require patient adherence and symptom self-management. OBJECTIVES The report presents the effects of a medication reminder and symptom management intervention directed at patients initiating new oral oncolytic agents. METHODS Patients (N = 272) were recruited at six comprehensive cancer centers, interviewed over the telephone after oral agent initiation, and randomized to either standard care or a medication reminder and symptom management intervention. In the intervention arm, the automated system called patients daily to remind them about taking their medications and weekly to assess 18 symptoms and refer patients to a printed Medication Management and Symptom Management Toolkit. Severity of 18 symptoms was also assessed during telephone interviews at Week 4 (midintervention), Week 8 (postintervention), and Week 12 (follow-up). Adherence was measured using the relative dose intensity, the ratio of dose taken by patient out of dose prescribed by the oncologist, and assessed using pill counts at Weeks 4, 8, and 12 and prescribing information from medical records. RESULTS The relative dose intensity was high and did not differ by trial arm. Symptom severity was significantly lower (P < 0.01) in the experimental arm at Week 8 but not at Weeks 4 or 12. CONCLUSION Adherence may be less of a problem than originally anticipated, and intervention was not efficacious possibly because of already high rates of patient adherence to oral oncolytic medication during first 12 weeks. Longer follow-up in future research may identify subgroups of patients who need interventions to sustain adherence.
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Affiliation(s)
| | | | | | - Eric Vachon
- Michigan State University, East Lansing, Michigan, USA
| | | | | | | | | | - Asish Banik
- Michigan State University, East Lansing, Michigan, USA
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