The effect of education to patient receiving oral agents for cancer treatment on medication adherence and self-efficacy

This quasi-experimental study has been conducted at Baskent University Hematology and Oncology in-patient/out-patient clinics and Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital Ambulatory chemotherapy clinics. Aim of the study was to examine the effect of the structured education using MASCC Teaching Tool (MOATT©) for patients receiving oral agents for cancer treatment on medication adherence and self-efficacy. Study sample included 41 patients receiving treatment at these hospitals.Data were obtained via using questionnaire, medication adherence self-efficacy scale (MASES), Memorial Symptom Assessment Scale (MSAS) and follow-up form (diary) for patient receiving oral chemotherapy. Patient who has received at least one course of oral chemotherapy and volunteered to participate were asked to complete forms and educated via using MOATT at scheduled time, supplemented with drug specific information, treatment scheme and diary. Phone interviews were done at one week and two week after educational session; when they are available during follow-up/before next cycle of treatment they asked to complete MSAS, MASES and questionnaire for medication adherence again. Data were analyzed with using descriptive statistics besides Wilcoxon, Pearson Correlation and Chi-square tests.Mean age was 51.8; majority of them were married and living with their mades and children, secondary or primary school graduates; more than half were diagnosed with breast cancer, one in forth had stomach cancer; most of them were using capecitabine as oral agent for cancer treatment combined with intravenous chemotherapy.Majority of patients were not using any tool for medication reminder, before and after education. It was found that before education more than half and after education almost all patients were keeping their drugs in their package, a cool and dark place, away from heat, sunlight and moisture.When asked about common medication taking behaviors, majority (90.2 %) were stated that they are not forgotten to take their medication. Most of them were experienced medication related side-effects (78%); mostly cited as nausea (69.7%); when examined the data from MSAS most of them had lack of energy, nausea, dry mouth, and taste alterations, lack of appetite, feeling nervous and constipation. In general mean score of symptom severity and perceived symptom distress were slightly decreased after education.Item mean of MASES on how confident are you can take your oral chemotherapy drugs were increased after education. When analyzed item correlations between pre and post education scores; eight items were correlated as 100% and were found statistically significant.It was shown that individual education and follow-up for patient receiving oral agents for cancer treatment increased their medication adherence self-efficacy. The use of MOATT for patient teaching and follow-up; evaluation of the effectiveness on medication adherence in long term, from beginning of the treatment to the end, and having further study with larger sample can be suggested.Key Words: Oral agents, medication adherence, self-efficacy.