Review Article

Adherence to Oral Therapies for Cancer: Barriers and Models for Change

Susan Moore, RN, MSN, ANP, AOCN®

From MCG Oncology, Chicago, IL.

Ms. Moore is a member of the Genentech Xeloda promotional speakers bureau.

Correspondence to: Susan Moore, RN, MSN, ANP, AOCN®, 5437 W Warwick Ave, Chicago, IL 60641. E-mail: smoore46@yahoo.com


J Adv Pract Oncol 2010;1:155–164 | DOI: 10.6004/jadpro.2010.1.3.2 | © 2010 Harborside Press


  

ABSTRACT

Adherence to orally administered cancer therapy is far from optimal. Theory-driven interventions are needed for optimal management of patients on oral anticancer regimens. Few models for assessing motivation, models for change theory, or educational techniques have been validated in oncology; none have been validated for patients undergoing oral therapies. Peer-reviewed nursing, medical, education, and social science literature; published monographs; and websites are reviewed to synthesize the history of adherence to oral therapies for cancer; barriers to adherence; and models from education, social science, and health-care disciplines that may provide a theoretical framework for patient and care-partner counseling. The Health Belief Model, Self-Regulation Theory, Transtheoretical Model of Change, Freierian principles, and motivational interviewing, commonly used in other disciplines, can be used for patient assessment and counseling, but must be validated in oncology and specifically in regard to adherence to oral therapies. Advanced practice oncology nurses and nurse researchers can assume leadership roles to validate existing patient education and motivation models as tools for optimizing patient experiences and outcomes during oral therapy regimens for cancer.


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