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 start‐of‐care training for the patients to self‐manage when oral anti‐cancer agents for treatment were prescribed.