Patients´ competence in oral cancer therapies.

Introduction: Oral agents in cancer therapy are increasingly prescribed. They are characterized by a considerable potential for side-effects, toxicity and drug interactions. Inadequate use of medication leads to ineffectiveness and in some cases may contribute to an early breakup. Subsequently, patients need a high level of self-management competence. We evaluated whether standardized recurring patient education by oncology nurses influences therapy adherence, self-management ability, and eventually therapeutic success. Methods: The intervention study was conducted in office-based oncology practices in Germany in 2014. Patients starting an oral cancer therapy for the first-time were included. Oncologists in the control group counseled their patients as usual. Oncology nurses in the intervention group were specially trained to repeatedly provide the patients with information on the clinical picture, side effects, and the proper handling of medication by using the MASCC Oral Agent Teaching Tool (MOATT) in addition to the oncologists counseling. Primary endpoint was the patient's competence measured by self-efficacy, quality of life and therapy related knowledge. Secondary endpoints were side-effects, health related stress, therapy adherence and breakup rate. Results: In total, 28 office based oncology practices (n = 195 patients, 57% women, 43% men) took part, 17 (n = 136 patients) in the intervention and 11 (n = 59 patients, 50% women, 50% men) in the control group. The mean age of patients in the intervention was 68 years, likewise in the control group. The results reveal a lower therapy interruption rate and a better coping with side-effects in the intervention group. Conclusions: Patients benefit from a standardized patient education program through specially trained oncology nurses. The development of patient centered counseling strategies for oncology nurses may become a corner stone in oral cancer care.