Oral oncolytic therapy offers convenience for patients, but adherence remains a challenge in oncology practice, according to Melissa Rikal, MSN, FNP-BC, AOCNP. Rikal, a nurse practitioner at Sarah Cannon Research Institute in Nashville, Tennessee, spoke with Oncology Nursing News following a Case-Based Roundtable discussion with peer oncology advanced practice providers (APPs) about strategies to improve adherence and patient education.
“Anytime somebody is on an oral oncolytic, we just worry,” Rikal explained. Patients often struggle with remembering daily doses, managing missed doses, and learning dosing schedules. Complex regimens, such as cycles of 4 days on and 3 days off, or multi-tablet dosing schedules, can add to confusion and increase the risk of nonadherence.
Rikal noted that newer agents like elacestrant (Orserdu), which uses a simple once-daily dosing schedule, reduce these barriers. However, patient education remains critical, even when pharmaceutical companies provide blister packs to simplify instructions. Oncology nurses and APPs play a key role in clarifying regimens, reinforcing adherence strategies, and ensuring patients understand what to do if they miss a dose.
Transcript
In general, anytime somebody is on an [oral] oncolytic, we just worry. Are they going to be able to take it as they should? Are they going to remember to take it every day? Are they going to take it at the appropriate time if they miss a dose? Are they going to double up? Educating on how to manage all of those situations, if they were to occur. With elacestrant, it’s a little bit easier, because it’s once-daily dosing. With a lot of our other oncolytics, there can be unique dosing, such as 4 days on and 3 days off, or 3 weeks on 1 week off or twice daily or multiple tablets for twice daily dosing.
We really must clarify. A lot of times, now, the pharmaceutical companies are creating that blister pack where it’s laid out exactly how many to take at which time of the day. But they still can get confused: if they have to take a week off, when does that new week restart? And it seems like they always get off on the dosing. With elacestrant, it’s very simple and that it’s once daily. It’s tough to mess up, as long as they remember to take it.
This transcript has been edited for clarity and conciseness.