Educational Framework Offers Guidance for Oral Chemo Safety at Home
One aspect that ambulatory oncology nurses must consider in the greater staffing conversation is the time spent on educating patients and caregivers about oral chemotherapy safety in the home setting. Developing an educational framework to guide those conversations not only ensures that all critical information is covered but also that it’s delivered in a standard and efficient process.
The Case of the Efficacy Explanation
Jenni is an oncology nurse practitioner in an outpatient medical oncology clinic. She is meeting with 70-year-old Don after his first cycle of cabozantinib for treatment of metastatic medullary thyroid carcinoma when he asks why the oncologist put him on a pill instead of using IV chemotherapy. “Is it because I don’t have long to live?” Don wonders.
Future of Nursing; Adults Ration Medication; Drug Parity Act
It’s been almost a decade since the Institute of Medicine—now the National Academies of Medicine (NAM)—released The Future of Nursing: Leading Change, Advancing Health report. Although many aspects of the nursing profession have been enhanced, still others are woefully lacking in change. Healthcare workplace safety incidents are still too high—up to 12 times higher than in the overall workforce—educational opportunities are still too expensive, and scope-of-practice authority is still too limiting in many states—all of which are ONS policy priorities.
Which of the Following Strategies Is an Example of Developing a Provider-Patient Relationship to Negotiate an Oral Adherence Plan?
A provider develops a partnership with a patient and negotiates behaviors to reach an agreement to adhere to oral chemotherapy medication. This is an example of which strategy?
b. Operant conditioning
c. Motivational interviewing
ONS Tackles Oral Chemotherapy Complexities
To ensure that patients and providers are equipped with the latest, most up-to-date knowledge and resources, ONS routinely works with patient advocacy groups, subject matter experts, and other provider organizations to develop and refine critical information for clinical practice. Following safety standards and meeting patient education requirements are critical to successful oral chemotherapy practice.
How Oncology Nurses Provide Quality Care Through Telephone Triage
As a direct line to the oncology team, the phone conversations between nurses and their patients can help address symptoms, foster valuable patient education, provide useful interventions, encourage side effect reporting, and identify potentially life-threatening situations. Ultimately, successful telephone triage requires a unique skill set for oncology nurses to communicate with their patients and recognize underlying issues.
Oral Adherence With Nerlynx® (Neratinib) Tablets: Patient Case
AS is a 58-year-old woman who was diagnosed at age 55 with a right infiltrating ductal carcinoma of the breast, identified as grade III, ER and PR positive, and HER2 positive. She had bilateral mastectomy, and tumor size was noted to be 2.8 cm. She had a positive sentinel lymph node. She was staged at IIB (pT2, pN1, M0). Her left breast was noted to have usual ductal epithelial hyperplasia and a 1.2 cm fibroadenoma. AS’s genetic testing revealed a BRCA1 mutation (BRCA1 c.3748G>T [p.Glu1250*]), which may confer an increased risk for breast cancer in the range of 46%–87%, and 39%–63% risk for ovarian cancer by age 70. As her patient history shows, she has some risk factors for nonadherence, including no support at home and some financial issues. Throughout her care, the team worked to communicate and prepare AS to help ensure adherence as much as possible.
Oral Adherence With Nerlynx® (Neratinib) Tablets: Introduction
The cancer treatment landscape has shifted with the emergence of new, targeted therapies. Development and use of oral oncolytics, targeted cancer therapies that can be taken by patients orally in their own homes, has increased in recent years. This increase is due in part to research in extra- and intracellular signaling pathways. By interfering with or blocking these signals, targeted drugs have become standard agents in cancer therapy. Oral oncolytics currently account for about 25% of the oncology pipeline of drugs in clinical development, and experts project that oral oncoloytic use will continue to rise.
Care Coordination Standardizes Monitoring for Patients Prescribed Oral Cancer Agents
Use of oral therapies requires healthcare teams to monitor patients for issues such as unreported side effects, medication nonadherence, and incorrect administration of medications. Although many patients do very well with this form of treatment, some patients, even with a significant amount of education before starting therapy, may have challenges.
How APRNs Can Support Patients During Oral Agent Treatment
Oral agents offer many patient benefits, one of which is the freedom to take the medication at home, allowing them to keep their daily routine and gain additional time and independence they would have spent traveling to the clinic for treatment. However, with that freedom comes additional patient responsibilities, and preparation from advanced practice RNs (APRNs) is necessary to ensure patients can self-manage symptoms and adhere to administration regimens. Research shows that patients experience severe symptoms on oral agents that may cause them to miss as many as one-third of the prescribed doses. How can APRNs empower patients to adhere to the treatment plan and ensure safe symptom self-management at home?
Communication, Organization Are Top Drivers of Oral Adherence in Clinical Trials
Oncology nurses know the challenges of patient adherence to oral cancer therapies. Every dose a patient misses can affect their outcomes and chance of survival. But in clinical trials, oral adherence has even broader implications: when a study is evaluating the efficacy of a drug, it depends on study participants taking it exactly as the trial outlines.
Study Investigates How Health Literacy Affects Adherence to Oral Cancer Medications
Ensuring patients adhere to oral medications for cancer can be a complex task, especially if patients have low health literacy. Oral medications for cancer continue to be more prevalent, but rates of adherence to oral therapy vary widely by population, cancer type, and level of education. At the 2018 American Society of Clinical Oncology Annual Meeting, researchers presented the results of a study that hypothesized health literacy’s connection to oral medication adherence and whether a multilevel intervention approach would result in greater adherence.
How Are You Tracking Patients on Oral Chemotherapy?
Oral cancer treatments are effective and practical and can provide a level of flexibility for patients, allowing them to seamlessly continue their treatments without the burden of infusion visits. With many patients receiving oral chemotherapy, oncology nurses must recognize complications that can arise regarding procedure and documentation in practice.
Tackling Adherence as More Oral Therapies Come to Market
As many as 25%–30% of all new antineoplastic agents in development are estimated to be oral, and almost half of the 300 medications in phase II and III clinical trials are oral medications. A paradigm shift is taking place in chemotherapy delivery. During a session at the Oncology Nurse Advisor Navigation Summit, ONS member Jan Tipton, MSN, RN, AOCN®, at the University of Toledo Medical Center in Ohio, discussed how cancer is making a shift to oral medications.