Adherence to Oral Anticancer Agents

Summary

The clinical use of oral anticancer (OAC) agents, particularly molecularly targeted agents, has grown dramatically in recent years, and it is expected that the rate of development, approval, and use of these medications will continue to increase. Maximal benefit from OAC agents can only be achieved if used properly, which is often difficult due to complex treatment regimens and dosing schedules. Suboptimal adherence can result in poor survival, side-effects and toxicities, unnecessary treatment change, and increased use of health resources. While home-based treatment offers many advantages, at the same time it requires that patients and caregivers assume primary responsibility for symptom management. Whereas traditional parenteral chemotherapy is administered in controlled clinical settings, the newer OAC medications are administered and monitored by patients and caregivers in the home.

BBPSB encourages research that will help to understand the individual-level factors that influence adherence: cognitive factors, affective factors, biological factors, and motivational factors. Adherence to OAC therapy should be viewed holistically and considered in the context of the patient’s clinical status, comorbid conditions, treatment expectations, and social situation. In addition to understanding the role of individual patient-level factors, it is also important to understand the role of clinicians (e.g., physicians, nurses), pharmacists, and caregivers in shaping adherence behavior.