Date of Conferral



Doctor of Nursing Practice (DNP)


Health Services


Andrea Jennings-Sanders


Oral oncolytics continue to come to market at an unprecedented pace. Traditionally, chemotherapy was delivered in the controlled environment of the infusion suite; however, with the increasing use of oral oncolytics, the burden of administration and monitoring has shifted to the patients and/or their caregiver. This paradigm shift, from intravenous chemotherapy to oral chemotherapy, has created new challenges in cancer care. Despite the seriousness of their diagnosis, oncology patients are not always adherent to these requirements. Oncology nurses have always taken the lead in patient education, yet that lead has mostly been in the context of intravenous chemotherapy. There is currently a lack of evidence to guide oncology nurses with their interactions with patients on oral chemotherapy. If patients are not adherent with their prescribed therapy, then progressive disease and premature death may be the outcome of their non-adherence. This project was a systematic review and synthesis of 51 articles on oral adherence and the subsequent development of a guideline based on the evidence that nurses can use to guide their interactions with patients on oral chemotherapy. The synthesis was divided into ways to measure adherence, factors contributing to non-adherence, and interventions to improve adherence. Knowing the factors contributing to non-adherence, how best to measure adherence, and the interventions to improve adherence can assist the nurse to plan individualized patient care. Adherence is critical for optimal patient outcomes and nurses play a key role in helping patients remain adherent. Education, monitoring, and ongoing support are necessary to help patients remain adherent and achieve optimal clinical outcomes. The scholarly product, a guideline on oral adherence, can be used by nurses to guide their interactions with adult patients on oral chemotherapy.

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