Interventions to enhance adherence to oral anti-neoplastic agents: A Scoping Review.

As new targeted oral anti-neoplastic therapies have emerged in recent years, the development of effective strategies that promote optimal adherence to cancer medication regimens has become an important priority.We conducted a scoping literature review to search for English language articles published through July 15, 2019 to identify studies that reported the testing and/or evaluation of interventions to improve adherence to oral anti-neoplastic agents.A total of 56 articles were selected for review. Of the studies evaluated, 14 were randomized trials. All interventions except two targeted adult patients. Thirty-three studies enrolled fewer than 100 patients. The majority of interventions were education and counseling-based and centered on provision of information about the drug and strategies to manage side effects. Only 8 studies used an mHealth tool and/or text messages to target non-adherence. Among studies with a comparison sample, fewer than half (44.7%) reported statistically significant improvements in adherence or persistence associated with the intervention; however, some pharmacist-directed programs, particularly those that integrated monitoring or routine follow-up with a provider, did demonstrate efficacy.Although the development of adherence-promoting interventions for oral anti-neoplastic therapies has increased recently, few have been rigorously tested. The nascent literature suggests those that are pharmacist-directed and utilize regular monitoring show promise though additional prospective studies are needed. Study methodology, population selection, and potential challenges that may be encountered in the implementation and dissemination phases should be considered when developing new interventions to address non-adherence to oral anti-neoplastic treatment.