• J Pain Symptom Manage · Nov 2018

    Randomized Controlled Trial Multicenter Study

    An Automated Intervention Did Not Improve Adherence to Oral Oncolytic Agents While Managing Symptoms: Results From a Two-Arm Randomized Controlled Trial.

    • Alla Sikorskii, Charles W Given, Barbara A Given, Eric Vachon, John C Krauss, Margaret Rosenzweig, Ruth McCorkle, Victoria L Champion, Asish Banik, and Atreyee Majumder.
    • Michigan State University, East Lansing, Michigan, USA.
    • J Pain Symptom Manage. 2018 Nov 1; 56 (5): 727-735.

    ContextAn increasing number of oral cancer treatments require patient adherence and symptom self-management.ObjectivesThe report presents the effects of a medication reminder and symptom management intervention directed at patients initiating new oral oncolytic agents.MethodsPatients (N = 272) were recruited at six comprehensive cancer centers, interviewed over the telephone after oral agent initiation, and randomized to either standard care or a medication reminder and symptom management intervention. In the intervention arm, the automated system called patients daily to remind them about taking their medications and weekly to assess 18 symptoms and refer patients to a printed Medication Management and Symptom Management Toolkit. Severity of 18 symptoms was also assessed during telephone interviews at Week 4 (midintervention), Week 8 (postintervention), and Week 12 (follow-up). Adherence was measured using the relative dose intensity, the ratio of dose taken by patient out of dose prescribed by the oncologist, and assessed using pill counts at Weeks 4, 8, and 12 and prescribing information from medical records.ResultsThe relative dose intensity was high and did not differ by trial arm. Symptom severity was significantly lower (P < 0.01) in the experimental arm at Week 8 but not at Weeks 4 or 12.ConclusionAdherence may be less of a problem than originally anticipated, and intervention was not efficacious possibly because of already high rates of patient adherence to oral oncolytic medication during first 12 weeks. Longer follow-up in future research may identify subgroups of patients who need interventions to sustain adherence.Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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