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Optimizing Adherence to Oral Anticancer Agents: Results from an Implementation Mapping Study.

Clinical trials inform cancer care, yet real-world outcomes often diverge due to patient-related factors, like age, organ dysfunction, and nonadherence to oral anticancer agents (OAAs). While oncology organizations emphasize patient support programs, practical guidance on designing and implementing...

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Published in:Current Oncology Vol. 32; no. 2; pp. 78 - 96
Main Authors: Muluneh, Benyam, Upchurch, Maurlia, Mackler, Emily, Bryant, Ashley Leak, Wood, William A., Wheeler, Stephanie B., Zullig, Leah L., Lafata, Jennifer Elston
Format: Journal Article
Published: MDPI Feb2025
Online Access:View this record in EBSCOhost
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      dt: Feb2025
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      pub: MDPI
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        10.3390/curroncol32020078
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        atl: Optimizing Adherence to Oral Anticancer Agents: Results from an Implementation Mapping Study.
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        au:
          Muluneh, Benyam
          Upchurch, Maurlia
          Mackler, Emily
          Bryant, Ashley Leak
          Wood, William A.
          Wheeler, Stephanie B.
          Zullig, Leah L.
          Lafata, Jennifer Elston
        affil: Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
      sug:
      ab: Clinical trials inform cancer care, yet real-world outcomes often diverge due to patient-related factors, like age, organ dysfunction, and nonadherence to oral anticancer agents (OAAs). While oncology organizations emphasize patient support programs, practical guidance on designing and implementing these programs is limited. We conducted a two-phase, mixed-methods study to enhance the adoption, implementation, and sustainability of an OAA adherence program (OAP). In phase 1, we used implementation mapping (IM) with a multidisciplinary expert panel to develop six strategies: (1) memorandum of understanding (MOU), (2) data-driven presentation, (3) standard operating procedures (SOPs), (4) motivational interviewing (MI) training, (5) electronic health record (EHR) templates, and (6) key performance indicators (KPIs). In phase 2, oncology professionals (n = 34) completed surveys, and a subset (n = 10) participated in interviews to assess feasibility, acceptability, and appropriateness. EHR templates and SOPs were rated as the most feasible and acceptable strategies, while MI training and formal agreements received moderate ratings. Interviews highlighted the importance of leadership buy-in, incremental implementation, and clear documentation. Participants valued KPIs for tracking adherence and outcomes but noted resource constraints and staff workload as challenges. Using IM, we co-developed strategies to activate OAA adherence-focused clinical programs. Tools standardizing care, like EHR templates and SOPs, were highly endorsed. Future work will test these strategies in a hybrid trial to improve real-world oncology outcomes.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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