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 Champion, Asish Banik, Atreyee Majumder

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Context: An increasing number of oral cancer treatments require patient adherence and symptom self-management. Objectives: The report presents the effects of a medication reminder and symptom management intervention directed at patients initiating new oral oncolytic agents. Methods: Patients (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. Results: The 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. Conclusion: Adherence 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.

Original languageEnglish (US)
JournalJournal of Pain and Symptom Management
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Randomized Controlled Trials
Patient Compliance
Mouth Neoplasms
Self Care
Telephone
Medical Records
Interviews
Neoplasms
Therapeutics

Keywords

  • adherence
  • Cancer
  • oral agents
  • symptom management

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

An Automated Intervention Did Not Improve Adherence to Oral Oncolytic Agents While Managing Symptoms : Results From a Two-Arm Randomized Controlled Trial. / Sikorskii, Alla; Given, Charles W.; Given, Barbara A.; Vachon, Eric; Krauss, John C.; Rosenzweig, Margaret; McCorkle, Ruth; Champion, Victoria; Banik, Asish; Majumder, Atreyee.

In: Journal of Pain and Symptom Management, 01.01.2018.

Research output: Contribution to journalArticle

Sikorskii, Alla ; Given, Charles W. ; Given, Barbara A. ; Vachon, Eric ; Krauss, John C. ; Rosenzweig, Margaret ; McCorkle, Ruth ; Champion, Victoria ; Banik, Asish ; Majumder, Atreyee. / An Automated Intervention Did Not Improve Adherence to Oral Oncolytic Agents While Managing Symptoms : Results From a Two-Arm Randomized Controlled Trial. In: Journal of Pain and Symptom Management. 2018.
@article{8569ca93246c461e97dcf2f9b2966746,
title = "An Automated Intervention Did Not Improve Adherence to Oral Oncolytic Agents While Managing Symptoms: Results From a Two-Arm Randomized Controlled Trial",
abstract = "Context: An increasing number of oral cancer treatments require patient adherence and symptom self-management. Objectives: The report presents the effects of a medication reminder and symptom management intervention directed at patients initiating new oral oncolytic agents. Methods: Patients (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. Results: The 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. Conclusion: Adherence 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.",
keywords = "adherence, Cancer, oral agents, symptom management",
author = "Alla Sikorskii and Given, {Charles W.} and Given, {Barbara A.} and Eric Vachon and Krauss, {John C.} and Margaret Rosenzweig and Ruth McCorkle and Victoria Champion and Asish Banik and Atreyee Majumder",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jpainsymman.2018.07.021",
language = "English (US)",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - An Automated Intervention Did Not Improve Adherence to Oral Oncolytic Agents While Managing Symptoms

T2 - Results From a Two-Arm Randomized Controlled Trial

AU - Sikorskii, Alla

AU - Given, Charles W.

AU - Given, Barbara A.

AU - Vachon, Eric

AU - Krauss, John C.

AU - Rosenzweig, Margaret

AU - McCorkle, Ruth

AU - Champion, Victoria

AU - Banik, Asish

AU - Majumder, Atreyee

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Context: An increasing number of oral cancer treatments require patient adherence and symptom self-management. Objectives: The report presents the effects of a medication reminder and symptom management intervention directed at patients initiating new oral oncolytic agents. Methods: Patients (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. Results: The 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. Conclusion: Adherence 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.

AB - Context: An increasing number of oral cancer treatments require patient adherence and symptom self-management. Objectives: The report presents the effects of a medication reminder and symptom management intervention directed at patients initiating new oral oncolytic agents. Methods: Patients (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. Results: The 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. Conclusion: Adherence 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.

KW - adherence

KW - Cancer

KW - oral agents

KW - symptom management

UR - http://www.scopus.com/inward/record.url?scp=85053117437&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053117437&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2018.07.021

DO - 10.1016/j.jpainsymman.2018.07.021

M3 - Article

C2 - 30096441

AN - SCOPUS:85053117437

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

ER -