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For Immediate Release: August 27, 2008
Oncology Practices Seek to Improve Patient Adherence with New Oral Chemotherapy Drugs
Oral Anti-Cancer Drugs Offer Advantages, But Adherence to Schedule and Dosing Is Vital
ROCKVILLE, Md.—In the past almost all chemotherapy for cancer treatment was delivered intravenously. Cancer care providers could monitor and assure that patients adhered to their schedule and correct dosage. Today the treatment landscape has changed.
"When patients take their own oral anti-cancer medications as part of their treatment regimen," said Richard B. Reiling, MD, FACS, past president of the Association of Community Cancer Centers (ACCC), "they must receive intensive teaching and monitoring—as much or even more than patients receiving intravenous therapy only. Oral chemotherapy is effective only if patients adhere to their administration schedule."
Dr. Reiling is chair of a special panel that will explore the benefits and barriers of oral chemotherapy drugs, as well as the complexity of managing adherence, at ACCC’s 25th Oncology Economics Conference in San Francisco, Calif., Friday, September 19, 2008. The panel will examine how the rapid growth of oral therapies for cancer care is affecting patients, physicians, and nurses.
On the plus side, oral chemotherapy agents are more convenient for most cancer patients. Because they will not require IV access, patients can avoid complications that occur with infusion, such as clotting and infections. Self-administration also means fewer trips to the hospital or physician's office. And there is some evidence that oral agents may have less severe side effects compared with intravenous therapies.
But adherence to treatment depends on many factors beyond the clinician’s control, including the patient's forgetfulness, decision to omit doses, emotional factors, and other priorities. Complex administration schedules and prohibitive costs are also in play.
"Educating cancer care providers about the issues and barriers to adherence is imperative," said Dr. Reiling. "Educated providers can then communicate this important information to their cancer patients." Education should address the dose, frequency, timing of dosing, what to do if a dose is omitted, and side effects.
Involving cancer patients in all aspects of the decision-making process has been shown to increase patient motivation and adherence. Regular follow-up is critical.
The panel moderator is Jodie Thellin Skyberg, Intellogy Health Designs. Panel members include Ranae Dahlberg, RN, BSN, UnitedHealthcare; Eric Nadler, MD, MPP, Texas Oncology, PA; and Karen Nicol, Arizona Oncology.