Oral Therapies for Multiple Myeloma Continuum

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Multiple Myeloma

Managing Patient Perceptions of Oral Anticancer Therapies

Lillie D. Shockney, RN, BS, MAS, ONN-CG 

Lillie_Shockley98pxFor many years, patients with multiple myeloma have been visiting an infusion facility to receive their cancer treatments. Although patients love their oncology team, trips to the infusion facility can take away quality time that they prefer to spend with their families and friends. The solution to this problem has been the development of new anticancer drugs that can be taken orally in the privacy of the patient’s home. As oncology navigators we say, “Great! An oral treatment option! Oh, wait, an oral treatment option?” This double-take happens because we lose control of knowing whether the patient is adhering to the medication as prescribed.

We know that there is an inherent problem with patients taking oral medications for chronic illnesses, and multiple myeloma is now considered a chronic illness (as are many other cancers today). When you think about it, even getting patients to adhere to oral medications for an acute illness can be challenging. Think about the last time you had a urinary tract infection. Did you take the antibiotics for the entire 7 to 10 days, or did you stop once you felt better, and stash the remainder of the prescription for when the symptoms returned?

Despite our medical education, even we can fall into the category of being nonadherent. Nonadherence has a lot to do with patients’ perceptions of how impor­tant the drug is to their health and specific medical situation, whether it is worth taking for their condition, whether they can manage and tolerate the side effects, and whether they recognize that the benefits of the drug outweigh its downsides.

Therefore, in an effort to promote adherence, you will read about methods for changing patient's perceptions of oral antimyeloma oncolytics.

You will also have the opportunity to read about ways nurse navigators can promote a patient’s adherence to a treatment plan, in a commentary by Deborah Christensen, RN, BSN, HNB-BC, Oncology Nurse Navigator at Dixie Regional Medical Center in St. George, UT.

In addition, we feature another commentary by Yelak Biru, MSc, who expands upon methods for increasing oral oncolytic adherence in patients, including being aware of telltale signs that indicate patients may not be taking their medications as prescribed.

This newsletter provides great insight and direction for nurse navigators so that we can recognize barriers to adherence, understand how to conduct adherence assessments, and—perhaps most importantly—learn about successful intervention strategies for improving patients’ outcomes. When you learn that a patient with multiple myeloma may begin a new oral agent, you will be able to say, “That’s great news, and I know how to help them stay on course with this cancer treatment.”

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