Oral Therapies for Multiple Myeloma Continuum

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Multiple Myeloma

Nurse Navigators Promote Patient Adherence to Treatment Plan

Deborah Christensen, RN, BSN, HNB-BC, Oncology Nurse Navigator, Dixie Regional Medical Center, St. George, UT 

Oral therapies for treating cancer are being developed at an unprecedented rate. Oncology providers, nurses, and pharmacists are now challenged with effectively helping patients manage their cancer treatments in the home setting. Oncology nurse navigators have an important role in helping patients understand their diagnosis, recommending treatments, and managing side effects. By keeping up-to-date with new therapies, communicating effectively with patients, and evaluating barriers to adherence, oncology nurse navigators can form trusting partnerships with patients while promoting best outcomes.

Keeping Current with New Drugs and Treatment Regimens

With the rapid expansion and approval of new therapeutic agents, oncology nurse navigators must develop strategies for keeping up-to-date with new releases and approved regimens. Some suggestions for remaining current on new developments in the treatment of patients with multiple myeloma (MM) include:

  • Joining the Academy of Oncology Nurse & Patient Navigators (AONN+). An AONN+ membership includes continuing education, a professional journal subscription, and access to other helpful resources
  • Making your inbox work for you. Sign up for e-mail updates and newsletters. The Multiple Myeloma Research Foundation, The Myeloma Beacon, and ScienceDaily deliver the latest news on MM
  • Attending educational programs. Pharmaceutical companies often provide drug-
    specific education on newly approved medications.

Communicating Effectively

Patients can overcome barriers to adherence when effective communication and mutual understanding occur between them and their oncology care team. A quality information exchange can be facilitated when oncology nurse navigators assume that all patients are challenged with accessing, understanding, and acting on unfamiliar oncology information. The Agency for Healthcare Research and Quality developed the Health Literacy Universal Precautions Toolkit, which provides evidence-based guidance that healthcare providers can use to improve patients’ comprehension of healthcare information.1 “Health Communication” is a free smartphone application that provides evidence-based communication tools, scenarios, and a quick reference guide on what to say to patients and caregivers in various situations.2 Research shows that patients’ understanding and ability to act on new knowledge is enhanced when healthcare providers use simple language, ask open-ended questions, actively listen, and assess for understanding.3

Assessing Barriers to Adherence

Assessing adherence barriers can be as simple as asking the patient an open-ended question, such as, “What problems may get in the way of following these instructions?” Evaluating self-efficacy—a person’s belief about their ability to complete a task—can help determine the likelihood for treatment adherence. For example, using a 1 to 10 scale with 1 being least likely and 10 being most likely, patients assign a number to the possibility of them taking their medication at the same time every day. Research shows that scores of ≥8 indicate a high probability for success. For scores <8, questioning why the score is not higher may help patients recognize potential barriers and develop strategies for adherence.


Teaching patients the importance of taking medications exactly as prescribed is discussed throughout this newsletter. By developing trusting relationships and a safe environment where patients can discuss potential or realized barriers, oncology nurse navigators can be positive forces in helping patients understand how to take their medications safely, and in the best way to potentiate optimal outcomes.


  1. Agency for Healthcare Research and Quality. AHRQ health literacy universal precautions toolkit. www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/index.html. Accessed January 14, 2016.
  2. iTunes. Health communications. https://itunes.apple.com/us/app/health-communication/id697289957?mt=8. Accessed January 14, 2016.
  3. Srivastava SB. The patient interview. In: Lauster CD, Srivastava SB, eds. Fundamental Skills for Patient Care in Pharmacy Practice. Burlington, MA: Jones & Bartlett Learning; 2014:1-35.

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