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Nurse Navigator Perspective: The Patient’s Role in Adhering to Oral Therapies

Conquering The Multiple Myeloma Continuum Series One
Deborah Christensen, MSN, APRN, AOCNS, HNB-BC
Oncology Nurse Navigator
St. George, UT

Instead of receiving cancer treatments in a hospital or outpatient setting, many patients are now being treated in the comfort of their own home with oral pills that they administer themselves. Suddenly, a patient is responsible for the 5 "medication rights of administration" that nurses must follow:

  • The right medication
  • The right dose
  • The right route
  • The right time
  • The right patient.

The fifth right, making sure that a medication is given to the right person, may not seem like a problem in the home setting, but pills must be kept away from children, pets, and other adults who could mistakenly take them.

Along with these 5 rights, patients are also being asked to watch for, report, and address their medication’s side effects. Some cancer medicines have to be taken at specific time intervals, with or without food, or aside from other medications. These instructions can disrupt a person’s normal sleep habits and daily routine. The high cost of cancer medications is another concern for most patients, as are the safe handling and storage of the pills.

Frequently Asked Questions

The following are suggestions for 3 of the most frequently asked questions about oral cancer treatments:

Q. What are some ways to help me take my medication exactly as it is prescribed?
Members of your healthcare team can help you develop simple strategies for getting used to taking a new medication. The "silly pat," patting your head or using another body gesture when taking your medication, has been shown to help people develop a new routine.

Chart your achievement on a calendar each time you take your medication as prescribed, and reward yourself with something nice at the end of a successful week. When you take your medication, send yourself a positive message by raising your water glass and toasting "to life."

Q. What financial resources can help with the cost of my cancer medication?
There are several financial resources for patients taking oral medications for multiple myeloma. The Leukemia & Lymphoma Society, Patient Access Network foundation, and Good Days have grants and copay assistance programs for qualifying patients. In addition, some drug companies have patient assistance programs for qualifying patients. Cancer centers often have staff dedicated to helping patients find national and local financial resources. Make sure to ask if assistance is available.

Q. What should I do if I experience side effects, such as diarrhea, nausea, or a rash?
Preparing for side effects can help you keep your life as normal as possible. If your medicine causes diarrhea, be prepared with extra clothing or wear protective briefs. Work with your healthcare provider to find the right solutions for nausea. Use sunscreen when outdoors, and notify your cancer care provider of any itching or a rash. Cancer therapy does not need to equal suffering.

Following the 5 medication rights is vital. As discussed in the feature article, taking less or more of a medication can have serious consequences for patients with cancer. Fortunately, barriers to adherence can be overcome when patients, caregivers, and the healthcare team work together toward that common goal.

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