Managing oral chemotherapy: the healthcare practitioner's role.

PURPOSE: [corrected] Management of the side effect profiles of the new oral cancer chemotherapeutic agents differs from those of traditional oral chemotherapy and hormonal therapy. The healthcare practitioner's role in counseling and managing these toxicities as well as methods for assessing and promoting adherence is reviewed.
SUMMARY: Many side effects from traditional oral cancer chemotherapeutic agents are the result of their effects on healthy cells as well as cancer cells. The side effects from the novel targeted therapies differ from those of traditional chemotherapy. Managing side effects and patient self-administration in non-traditional settings without supervision may affect patient adherence, especially with the newer agents. Social and psychological factors also can affect adherence. Various methods are available to assess adherence, including obtaining prescription refill histories and performing pill counts. Counseling patients, asking patients to keep a diary of doses and side effects, and following up with patients at clinic visits or through telephone contact are all methods that promote adherence. Patient education should address the proper dose, frequency, timing with respect to food and other medications, what to do if a dose is missed, side effects to anticipate, and what to do if side effects occur.
CONCLUSION: Healthcare practitioners play an important role in educating patients regarding potential side effects to oral chemotherapy and assessing and promoting adherence to the treatment regimen.