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Seminars in Oncology Nursing Features Articles on Oral Adherence


The May 2011 issue of Seminars in Oncology Nursing is focused on adherence to oral therapies for cancer. Guest editors Barbara A. Given, PhD, RN, FAAN, Michigan State University, and Marcia Grant, DNSc, RN, FAAN, City of Hope National Medical Center have compiled seven articles into a comprehensive body of work covering the wide variety of issues associated with adherence to oral cancer therapies. Although oral oncolytics agents have been in use for nearly six decades,1 the increasing prevalence of regimens that include oral agents has changed the way nurses approach caring for patients with cancer. Complex dosing regimens, oral agent side effects and toxicities, and long-term use are challenging to manage.2 Although we assume that patients are adherent with their oral therapy, direct observation and reported suboptimal adherence rates prove that not to be the case.3

The articles appearing in the issue and the respective authors are:

The Challenges of Oral Agents as Antineoplastic Treatments
Barbara A. Given, Sandra L. Spoelstra, and Marcia Grant

Oral Agents in Cancer Treatment: The Context for Adherence
Debra Barton

Assessment and Measurement of Adherence to Oral Antineoplastic Agents
Sandra L. Spoelstra and Charles W. Given

Interventions to Promote Adherence with Oral Agents
Susan M. Schneider, Kimberly Hess, and Tracy Gosselin

Age Span Challenges: Adherence in Pediatric Oncology
Wendy Landier

Adherence and Oral Agents with Older Patients
Kristen W. Maloney and Sarah H. Kagan

Policy Implications of Oral Agents
Sandra L. Spoelstra, Barbara A. Given, Charles W. Given, and Marcia Grant

Each of the articles contains background information for nurses who seek evidence-based guidance to maintain or improve their care of patients taking oral oncolytics. The issue as a whole provides a platform for changing practice, writing policies and procedures, and advocating for public health policy as we continue to care for increasing cancer prevalence in an aging population. The full text articles are available to subscribers or can be purchased online. The link to the May 2011 issue is http://www.seminarsoncologynursing.com/issues/contents?issue_key=S0749-2081(11)X0002-5

ManageCRC.com Commentary

Nonadherence in patients with cancer is particularly troublesome to oncology healthcare providers. Dosing regimens are based on carefully designed clinical trials and self-modification or early discontinuation of prescribed oral oncolytics may lead to disease progression and premature death. Nurses often claim that they have little to do with oral oncolytic patient education because the medication is prescribed by the physician (or advance practice RN) and, therefore, patients should be educated by the physician. In fact, the same situation is found with parenteral oncolytics. The physician prescribes and the nurse completes the circle by educating the patient and caregiver. Only the setting for the drug administration is different: Oral oncolytics are taken in the home, not in the infusion center. But the responsibility for safety belongs to everyone and optimal adherence can only be assured when all the players – patient, caregiver, physician and nurse - actively participate in the process.


  1. Weingart SN, Brown E, Bach PB, et al. NCCN task force report: Oral chemotherapy. J Natl Compr Canc Netw 2008;6(suppl 3):S1-S14. Link to free, full text http://www.nccn.org/JNCCN/PDF/JNSU3_combined_Oral_Chemo_2008.pdf
  2. Given BA, Grant M. Introduction. Semin Oncol Nurs. 2011;27:91-92. doi:10.1016/j.soncn.2011.02.001 No abstract available.
  3. Partridge AH., Avorn J, Wang PS, Winer EP. Adherence to therapy with oral antineoplastic agents. J Nat Cancer Inst 2002;94:652-661. doi: 10.1093/jnci/94.9.652

Article Created On : 5/9/2011 10:01:20 AM             Article Updated On : 5/9/2011 10:01:20 AM