Improving Adherence to Oral Cancer Agents and Self Care of Symptoms Using an IVR

This longitudinal randomized trial tests and compares two strategies for improving patient adherence to their oral medication prescriptions. The first strategy provides daily reminders to take cancer medications immediately after the medication has been prescribed. The second strategy provides daily reminders to take cancer medications only to patients who report difficulty taking their cancer medication as prescribed during the first 8 weeks of the study. Both strategies incorporate symptom management support using IVR for symptom assessment and a printed evidence-based Toolkit with helpful strategies and information for symptom management. A control group, without daily reminders, will be used for comparison. Aims 1. Cancer patients assigned to the intervention will have greater adherence to their prescribed regimen a) at weeks 4 (immediate effect), and b) at weeks 8, and 12 weeks (sustained effect). 2. When compared with patients receiving weekly assessments only, patients receiving weekly assessments plus daily adherence reminders and printed symptom management strategies for 4 weeks will report: lower symptom severity during weeks 2-4 that will be sustained at weeks 5-8, and at 12 weeks. Three exploratory aims are assessed: 1. To test how patient characteristics (age, sex, depression), dose variation, symptom severity, and concurrent infusion therapy moderate the impact of the novel intervention on adherence at 4, 8, and 12 weeks. 2. To test the impact of the novel intervention on dose alterations, emergency department visits and hospital admissions over the 12 weeks in order to support the translation of this system into oncology practices. 3. To determine the efficacy of the 4-week intervention (daily reminder calls and weekly symptom management) for patients in the control group who are non-adherent at 8 weeks from starting the oral agent.