Abstract A74: Cancer Care Providers' Perspectives on Medication Adherence for Cancer Patients on Oral Chemotherapeutic Agents: A Qualitative Assessment
Authors: Torres Essie , Richman Alice , O'Rorke Shawna , Field Paige , Carlston Lauren 
Published: March 2017

Abstract
Background: In recent years, the use of oral chemotherapeutic agents (OCAs) to treat cancer have increased greatly and is expected to continue to increase. According to the World Health Organization, non- adherence with OCAs is the most modifiable factor that can compromise treatment outcomes. WHO estimated that only about 50% of patients take their medications as prescribed, however, adherence varies with compliance rates as low as 16%. The objective of this study is to understand cancer care providers' (oncologists, oncology nurse navigators, and oncologist pharmacists) perspectives regarding challenges patients who are on Oral Chemotherapeutic Agents (OCAs) have adhering to their treatment plans as well as facilitators to adherence.
Methods: We conducted 2 focus groups (N= 9) and 2 interviews (N=2), January and February 2016, with 11 cancer care providers practicing in a regional Cancer Center in eastern North Carolina (ENC). The cancer care providers were asked to share their experiences with medication adherence of OCAs among their patient population, and discuss individual-level and structural-level factors that might influence sub-optimal adherence among this population. Participants were also asked about effective strategies they use to help their patients with their medication adherence.
Results: The results from this study helped identify and understand the unique factors that contribute to non-adherence to OCAs among the cancer patient population served in ENC. The barriers to adherence to OCAs occur at different levels: policy level (i.e. drug costs and insurance related issues), interpersonal level (i.e. social support, provider communication, and complexity of the regimen), and individual level (i.e. patient related characteristics: education level, health literacy level, anxiety level, and older age). The facilitators identified as increasing adherence to OCAs are: multiple levels of education and reinforcement (i.e. face-to-face, using patient portal system, and repetition of information by cancer care team), social support networks, reminder systems, and nurse navigation program. Cancer care providers reported that utilizing multiple strategies were the most effective in increasing medication adherence among their patient population.
Conclusion: This study has identified some modifiable barriers that can help increase medication adherence at multiple levels. The next phase of this study will use results from the formative research phase (identified barriers and facilitators) to develop a tailored nurse coaching intervention component that will significantly improve medication adherence among patients who are at high-risk for non-adherence.
Supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this abstract are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp.
Citation Format: Essie Torres, Alice Richman, Shawna O'Rorke, Paige Field, Lauren Carlston. Cancer Care Providers' Perspectives on Medication Adherence for Cancer Patients on Oral Chemotherapeutic Agents: A Qualitative Assessment. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A74.