Feasibility of OncoMed to Improve Self-Management and Adherence to Oral Anticancer Medications

Newer oral anti-cancer medications, specifically molecularly targeted tyrosine kinase inhibitors (TKIs) medications have improved the overall prognosis of patients with cancer. When properly adhered to, these medications can extend progression-free survival by several years. Despite the promise of TKIs, nonadherence is problematic and poor adherence is of significance as it is associated with disease progression and mortality. Despite the importance of optimal adherence (90% for TKIs), only a handful of interventions have included on adherence to the newer molecularly targeted TKI oral medications. Patients taking TKIs have fewer opportunities to be directly observed in clinic, therefore the burden of accurate medication administration and compliance rests with patients at home, presenting a challenge to medication adherence and symptom and toxicity monitoring. Strategies that (a) facilitate patient-provider communication about side effects and symptom monitoring, and (b) incorporate evidence-based tools to improve symptom monitoring and management, uncertainty tolerance and coping with illness-related stress may be specially beneficial to aiding cancer patients optimally adhere to these medications. We propose that an evidence-based psychosocial intervention that can improve management of oral anticancer medication side effects and improve health-related quality of life in cancer patients may also improve medication adherence. Consistent with PA-17-061, we propose to establish the feasibility of an evidence-based, web-based and adaptive program called OncoMed to improve adherence to TKIs. OncoMed is grounded in models of health behavior change, self-management and established barriers (e.g., patient factors, system/provider factors, treatment factors) of medication adherence. OncoMed will incorporate patient education (e.g., compliance education, medication adherence benefits), weekly medication side effect tracking and linking of patient-reported side effects to o