Pattie Jakel Highlights the Challenges With Oral Therapies in Breast Cancer


Patricia Jakel, RN, MN, AOCN, underscores some of the challenges nurses face when promoting adherence to oral medications.

In an interview with Oncology Nursing News®, Patricia Jakel, RN, MN, AOCN, discusses the challenges for patients taking oral therapies. Jakel recently presented on nursing considerations for managing patients with breast cancer, alongside La-Urshalar Brock, MSN, FNP-BC, CNM, as part of a PER® event during the 48th Annual oncology Nursing Society Congress.

Jakel notes that an increase in oral therapies has been seen as new agents move through the research and development pipeline, and the FDA grants accelerated or regular approvals. In breast cancer, certain oral agents offer significant advantages to patients, as they allow them to manage their care at home, and reduce the time spent commuting and being in a clinic. However, adherence with some of these agents represents a challenge.

In Jakel’s clinical experience, patient age, a lack of social support at home, and low health literacy can all represent driving factors of low adherence. In addition, some of these agents have very high co-payments. She highlights a story of a friend of hers whose co-payment with abemaciclib (Verzenio) was $3000 per month before she was able to secure a Lilly grant.

“When she chose Medicare Part D, she didn’t think about that,” Jakel says. “She cannot change right now because November has passed. Fortunately, Lilly has a grant, and they were able to get her the grant. So, there are ways around that, but it really does scare patients.”

Moreover, because oral medications are managed at home, some patients do not call when they are experiencing a problem. With so many different modes of communication available between health care providers and patients, sometimes patients may get confused as to who to call and when.

“Some [patients] will call, some won’t call,” Jakel says. “You have to really educate [them] and you have to keep reinforcing that education. Even though 10 people have told them the same thing, they may have to ask 1 more time.”

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