A trial examining an advanced practice nurse intervention to promote medication adherence and symptom management in adult cancer patients prescribed oral anti-cancer agents: study protocol

Aim. To report a study protocol that refines then examines feasibility, preliminary efficacy and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behaviorial therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents. Background. Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centres to patients and their caregivers. Thus, a need exists to standardize start-of-care to support patient self-management of care at home. Design. A two-phase quasi-experimental sequential design with repeated measures. Methods. Sixty-five adult patients newly prescribed an oral anti-cancer agent will be recruited from three community cancer centres. Phase 1 will enrol five patients to refine the ADHERE intervention prior to testing. After completion, Phase 2 will enrol 30 patients who receive usual care. Advanced practice nurses will then be trained. Thirty patients will be then enrolled in the intervention group and provided ADHERE, a 4-week intervention using semi-structured interactions (initial face-to-face session and once a week phone sessions over 3 weeks) and a Toolkit to promote self-management of care. Outcome measures include: oral anti-cancer agents adherence rate, symptom presence and severity, feasibility and satisfaction with ADHERE. This protocol was approved January 2014. Discussion. This nurse-led intervention has the potential to standardize the startof- care training for the patients to self-manage when oral anti-cancer agents for treatment were prescribed.