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Effects of Patient Education on Medication Adherence in Hematology-Oncology Rachel Myers Question P: In hematology-oncology patients, I: what is the effect of individualized education O: on medication adherence of oral chemotherapy agents and adjuvant medications at home? Background Becoming more common in the setting of hematology-oncology for patients to receive oral chemotherapy drugs and complex medication regimens upon discharge. The issue of medication adherence at home can be linked to high 30-day readmission rates in this patient population. The goal of this research is to study the effects of individualized education on overall patient self-management of oral medications. Implications/Conclusions •Knowledge of patient medication adherence and current policies on patient education was stronger following the educational flyer •Continuous education needs to be implemented in order to ensure full medication regimen adherence within hematology-oncology units Review of the Literature Study: author, Year Sommers, R. M., Miller, K., & Berry, D. L. (2012). Case-Control Study Methods •Anonymous pre- & post-survey which includes experience, knowledge and practice •Educational brochure on proper policy and procedure of patient and family education and current literature of medication adherence •From adult and pediatric Hem-Onc units •N=19 pre-survey •N=16 post-survey Results •84%: 1-15 years of experience •0% answered that it was not necessary to assess education for readmitted patients •Teach Back is best teaching method per Hershey policies and procedures •79% of participants agreed in the pre-survey whereas, 100% agreed in the post-survey •Post-survey: 56% said they use the Teach Back method quite often, while 44% said they use it every time upon discharge •79% of participants in the pre-survey believed that education had significant effects on medication adherence, while 100% believed that in the post-survey Sui-Fun, W., Bounthavong, M., Cham, N., Bechtoldt, K., & Hernandez, E. (2014) Observation Cohort Wu, S., Chee, D., Ugalde, A., Butow, P., Seymour, J., & Schofield, P. (2015) Qualitative Study Subjects Interventions/ Control Groups N=30 patients with Verbal and written gastrointestinal cancer education who and a nurse-initiated were prescribed at educational telephone least one oral call within 72 chemotherapy agent hours of receiving education. N=30 clinic patients (9 Comprehensive men and 21 women medication therapy with a mean age of management (MTM) 64.5 years): majority had advanced-stage cancer and no live-in caregiver. N=16 patients and N/A N=10 health professionals (hematologists n = 4, nurses n = 3, pharmacists n = 3) Outcome Measures A medication diary at home during the first cycle and the eight-item Morisky Medication Adherence Scale (MMAS-8) Significant Results * include p values At the end of the first cycle of therapy, MMAS-8 adherence scores were high (X = 7.89, SD = 0.55). Intervention outcomes were collected at Rates of optimal oral chemotherapy adherence baseline and at follow-up and persistence increased by70%. visits/interviews for up to three months Semi-structured qualitative interviews were recorded, transcribed, and manually analyzed using interpretive phenomenological analysis Reasons for unintentional nonadherence included forgetfulness related to variations of routine and doctor–patient communication issues. Reasons for intentional nonadherence included desires to reduce dose-dependent side effects and insufficient support. References Sommers, R. M., Miller, K., & Berry, D. L. (2012). Feasibility pilot on medication adherence and knowledge in ambulatory patients with gastrointestinal cancer. Oncology Nursing Forum, 39(4), E373-9. Sui-Fun, W., Bounthavong, M., Cham, N., Bechtoldt, K., & Hernandez, E. (2014). Implementation and preliminary outcomes of a comprehensive oral chemotherapy management clinic. American Journal Of Health-System Pharmacy, 71(11), 960-965. doi:10.2146/ajhp130278 Wu, S., Chee, D., Ugalde, A., Butow, P., Seymour, J., & Schofield, P. (2015). Lack of congruence between patients' and health professionals' perspectives of adherence to imatinib therapy in treatment of chronic myeloid leukemia: A qualitative study. Palliative & Supportive Care, 13(2), 255-263. doi:10.1017/S1478951513001260