Susan Moore, RN, MSN, ANP, AOCN® Oncology Nurse Practitioner/Consultant at MCG on the importance of oral oncolytic patient education.

Moore says the key is for nurses to educate their patients. She says that from day one in nursing school nurses learn to educate their patients and it's a skill that is refined over the years. Moore advises against using a script and recommends an individualized approach tailored to the patient. It also helps to have a member of the patient's family or a friend there because they may hear things differently from the patient, who may be experiencing anxiety.

A nurse should educate a patient not just once but every time they have an encounter with the patient while they're on the medicine, whether if it's in the clinic or over the phone. Nurses should ask how the patient is doing, ask if they missed any medication, ask why they missed any medication, and offer to help the patient get back on track with the medication. Moore says education can be quick, but must be done continually.

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Susan Moore on the Importance of Oral Oncolytic Patient Education

Susan Moore on Oral Oncolytic Patient Education

Susan Moore, RN, MSN, ANP, AOCN® Oncology Nurse Practitioner/Consultant at MCG explains nonadherence to oral oncolytics.

Moore says at this point the majority of evidence comes from women with early stage breast cancer who have been given, for example, a five year regimen of tamoxifen or an aromatase inhibitor that they take after their surgery and any adjuvant chemotherapy that they happen to have. Women tend to fall off those therapies, sometimes as early as two or three years after starting. The incidence of nonadherence increases as a woman goes along in that one to five year range. In patients that are taking imatinib for chronic myelogenous leukemia (CML), it is relatively easy to measure their BCR and see what their level is. That level will more or less indicate whether or not a patient is being adherent. Moore says those are areas where definite evidence is available, but in many other cases the evidence is anecdotal.

Susan Moore Explains Nonadherence to Oral Oncolytics

Susan Moore Explains Oral Oncolytic Nonadherence

Susan Moore, RN, MSN, ANP, AOCN® Oncology Nurse Practitioner/Consultant at MCG on the effects of nonadherence to oral oncolytics.

Moore says an effect of nonadherence to oral oncolytics can be a lowered efficacy. All of the data given to a patient that illustrates a certain success or survival rate is dependent upon the completion of treatment regimens. The rate given to patients is based on full compliance, not if a patient, for example, takes the medication for six months then stops for three months and starting again. It is based on taking the medicine every day, or as ordered, for the length of time that it is ordered.

Another effect occurs when patients do not take medications as ordered: increased toxicity. When patients take too much medication or continue taking it when told to stop, they can have increased toxicity, or end up with toxicities that are so severe that the medication has to be stopped because of the toxicity and not because it stopped working.

Susan Moore on Effects of Nonadherence to Oral Oncolytics

Susan Moore on Nonadherence to Oral Oncolytics

Susan Moore, RN, MSN, ANP, AOCN® Oncology Nurse Practitioner/Consultant at MCG on predictors of poor oral oncolytic adherence.

Moore says that patients who tend not to follow instructions during the time of their adjuvant therapy miss appointments and have poor refill rates with their retail pharmacy. As a prescriber, a physician can access refill records by calling the pharmacy. Moore says that physicians should think carefully about prescribing chemotherapy to a patient who fails to do those things or fails to call the clinic to tell the nurse or physician about a side effect, because the side effects and the failure to adhere to the treatment can cause toxicity and other problems.

Susan Moore on Predictors of Poor Oral Oncolytic Adherence

Susan Moore, RN, MSN, ANP, AOCN® Oncology Nurse Practitioner/Consultant, MCG describes the advantages of oral oncolytics.

Moore says that an advantage for the patient is that they can take the medication home instead of having to schedule appointments to go into the clinic to be treated. It can give patients an increased sense of control and the sense that they are somewhat in charge of their treatment. Patients aren't making decisions about the doses and they are following physicians' instructions on how to take it, but it gives the patient a little more control than having to go into the clinic for treatment.

Susan Moore Describes Advantages of Oral Oncolytics