Action Plans and Educational Resources Found to Increase Oral Medication Compliance in Patients with Breast Cancer

Adherence to medication is key to patient health outcome success.¹ Poor adherence can result in worsening of medical conditions, increased co-morbidities, and possible death.¹ Additionally, poor medication compliance can lead to increased overall healthcare spending.¹ The 3 factors that often lead to poor medication compliance are healthcare providers, patients, and medications.¹ Providers can fail to educate patients on dosages, timing, frequency, side effects, and costs of prescribed medications.¹ Patient factors include mental health issues, illiteracy, taking multiple medications, alcohol use, cultural or religious issues, and socioeconomic status/lack of insurance, which may make medication cost prohibitive.¹ Medication factors include side effects, dosage forms, size, frequency of use, cost, and timing.¹ With the development of novel oral cancer medications, patients and their caregivers are becoming increasingly responsible for medication adherence and management of medication side effects.

To improve outcomes in patients with HR+/HER2− breast cancer receiving oral oncolytics, a quality improvement initiative was undertaken to determine the gaps in patient and provider education, adverse risk management, risk reduction, and shared decision making. Surveys were completed by 111 patients with HR+/HER2− breast cancer and 54 healthcare providers who treat breast cancer. The surveys were designed to assess challenges, attitudes, and values related to therapy adherence, education, and clinical practice patterns. Additionally, healthcare providers participated in audit-feedback and developed practice care improvement plans. The improvement plans were implemented in follow-up patient-provider educational sessions.

The top challenges providers reported were patient-centered supportive care measures (reported by 32% of providers), patient adherence/lack of follow-up (22%), and individualizing treatment plans (17%). Improved collaboration across treatment teams was reported by 43% of providers as the most likely to improve patient care. Challenges on the patient side included 33% of patients who worry about and/or have difficulty managing side effects, 29% reported difficulty in scheduling appointments or follow-ups, and 19% reported difficulty in communicating with their healthcare teams. Not having medication nearby or forgetting to take medication was reported by 36% of patients, cost by 21%, and side effects by 21% as reasons for missing or skipping medication doses. Using this data, healthcare providers developed action plans such as using patient navigators, providing patient-provider educational visits, identifying patients at high risk for medication noncompliance, and educating staff and patients about supportive care resources. After patient-provider collaborative education sessions, 48% of patients reported improved knowledge levels of breast cancer treatment options, 41% reported improved knowledge of side effects and 52% reported using alarms or other reminders to take medication in a timely manner.

Source:

Meisel, J, Anderson C, Dewald I, et al. Advancing treatment and management of patients with HR+/HER2- breast cancer: Findings from a quality improvement initiative. Poster presented at: San Antonio Breast Cancer Symposium. December 8, 2023; San Antonio, TX. Abstract # PO5-05-04.

Reference:

1. Aremu TO, Oluwole OE, Adeyinka KO, Schommer JC. Medication adherence and compliance: recipe for improving patient outcomes. Pharmacy (Basel). 2022;10:106.