Optimizing Adherence to Oral Anticancer Agents: Results from an Implementation Mapping Study

Area of Science:

• Oncology
• Implementation Science
• Health Services Research

Background:

• Real-world cancer care outcomes frequently differ from clinical trial results due to patient-specific factors, including nonadherence to oral anticancer agents (OAAs).
• Existing oncology guidelines recommend patient support programs, but practical implementation guidance remains scarce.

Purpose of the Study:

• To enhance the adoption, implementation, and sustainability of an OAA adherence program (OAP) using a mixed-methods approach.
• To co-develop practical strategies for improving OAA adherence in clinical settings.

Main Methods:

• A two-phase, mixed-methods study employing implementation mapping (IM) with a multidisciplinary expert panel.
• Phase 1: Development of six core strategies. Phase 2: Assessment of strategy feasibility, acceptability, and appropriateness through surveys and interviews with oncology professionals.

Main Results:

• Six key strategies were developed: memorandum of understanding (MOU), data-driven presentation, standard operating procedures (SOPs), motivational interviewing (MI) training, electronic health record (EHR) templates, and key performance indicators (KPIs).
• EHR templates and SOPs were identified as the most feasible and acceptable strategies.
• Leadership support, phased implementation, and clear documentation were crucial for success, while resource limitations and staff workload presented challenges.

Conclusions:

• Implementation mapping effectively co-developed strategies to establish OAA adherence programs.
• Standardized clinical tools, specifically EHR templates and SOPs, are highly valued for improving OAA adherence.
• Future research should evaluate these strategies in a hybrid trial to enhance real-world oncology patient outcomes.