Improving Adherence to Oral Cancer Agents and Self Care of Symptoms Using an IVR

Improving Adherence to Oral Cancer Agents and Self Care of Symptoms Using an IVR The goals of this study are to improve adherence to oral chemotherapeutic medications and self-management of symptoms among cancer patients. More than 40 oral agents currently are on the market with projections that in three years 30% of the cancer treatment agents will be delivered in oral form. As a result, patients must assume responsibility for taking medications and self-management of associated side effects. This longitudinal randomized trial tests and compares 'two strategies' for improving patient adherence to their oral cancer medication prescriptions to standard care. Both strategies incorporate symptom management support using an interactive voice response system (IVR) for symptom assessment and a printed evidence-based Medication Management and Symptom Management Toolkit (Toolkit) with helpful strategies and information for symptom management. We will collaborate with NCI Comprehensive Cancer Centers to recruit patients into this study. Recruiters will identify patients as they are prescribed oral cancer medications, present the study to the patient, and ask them to consent to be part of the study. Study Aims Following are the Aims of the study. 1. Cancer patients assigned to the intervention will have greater adherence to their prescribed regimen: a) at week 4 (immediate effect), and b) at weeks 8 and 12 (sustained effect). 2. When compared with patients receiving weekly assessments only, patients receiving weekly assessments plus daily adherence reminders and printed symptom management strategies for 4 weeks will report: lower symptom severity during weeks 2-4 that will be sustained at weeks 5-8, and at 12 weeks. Two exploratory aims are assessed: 1. To test how patient characteristics (age, sex, depression), dose variation, symptom severity, and concurrent infusion therapy moderate the impact of the novel intervention on adherence at 4, 8, and 12 weeks. 2. To test the impact of the novel intervention on dose alterations, emergency department visits and hospital admissions over the 12 weeks in order to support the translation of this system into oncology practices.

Sex

All

Minimum age

21 Years

Inclusion Criteria:

* 21 years of age or older
* Newly prescribed one of the designated oral cancer medications for treatment of cancer
* ECOG score of 0,1,or 2 OR Karnofsky score of 50 or higher
* Patient of one of the participating National Cancer Institute comprehensive cancer centers
* Able to speak, read and understand English
* Able and willing to receive phone calls

Exclusion Criteria:

* Difficulty hearing on the telephone
* Limited or no access to a touch tone phone
* Cognitive deficits
* Hospice care at enrollment
* Those prescribed a hormonal therapy for cancer

• DERIVEDMarshall VK, Given CW, Given BA, Lehto RH, Sikorskii A. Factors affecting medication beliefs among patients newly prescribed oral oncolytic agents. J Psychosoc Oncol. 2022;40(1):62-79. doi: 10.1080/07347332.2020.1855497. Epub 2020 Dec 11. PMID 33305993
• DERIVEDSikorskii A, Given CW, Given BA, Banik A, Krauss JC. Patient Engagement With an Automated Telephone Symptom Management Intervention: Predictors and Outcomes. Ann Behav Med. 2020 Jun 12;54(7):484-494. doi: 10.1093/abm/kaz067. PMID 31925414
• DERIVEDDecker V, Sikorskii A, Given CW, Given BA, Vachon E, Krauss JC. Effects of depressive symptomatology on cancer-related symptoms during oral oncolytic treatment. Psychooncology. 2019 Jan;28(1):99-106. doi: 10.1002/pon.4916. Epub 2018 Oct 23. PMID 30311987