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ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications

Sarah M. Belcher

Emily Mackler

Benyam Muluneh

Pamela Ginex

Mary K. Anderson

Elizabeth Bettencourt

Ryan K. DasGupta

Erica Hall

Jennifer Elliott

Michelle Karlin

Diana Kostoff

Victoria K. Marshall

Vanessa E. Millisor

Maegan Molnar

Susan M. Schneider

Janelle Tipton

Susan Yackzan

Kristine B. LeFebvre

Kapeena Sivakumaran

Haya Waseem

Rebecca L. Morgan

guideline, oral anticancer medications, medication adherence, oncology nursing

Purpose: This evidence-based guideline intends to support patients, clinicians, and others regarding interventions and processes to support patient adherence to oral anticancer medications (OAMs).

Methodologic Approach: A panel of healthcare professionals and patient representatives developed a clinical practice guideline to support patients taking OAMs. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology and criteria for trustworthy guidelines were followed. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. A quantitative or narrative synthesis of the evidence was completed. Certainty of the evidence was assessed using GRADE.

Findings: The panel agreed on recommendations and suggested an adherence risk assessment, education addressing adherence, ongoing assessment, proactive follow-up, coaching, and motivational interviewing in addition to usual care. The panel suggested the implementation of a structured OAM program.

Implications for Nursing: As cancer treatment shifts from clinic to home settings, interventions and programs to support patients on OAMs are needed.

Supplementary material can be found at

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