Oral medication adherence, attitude, and quality of life in older adults with cancer: The impact of motivational interviewing

Abstract

<p>Oral medication adherence in the older adult with cancer, age 65 years and older, is a significant clinical problem. Adherence rates are estimated at only 50%, which can lead to suboptimal treatment efficacy, poor symptom control, and reduced survival. Patient attitudes and beliefs can improve oral medication adherence and quality of life, while reducing unnecessary emergency room visits, and hospitalizations. Motivational interviewing (MI) is a communication intervention that has been shown to improve oral medication adherence in persons with chronic illness, including cancer. The purpose of this evidence-based practice (EBP) project was to explore the influence of MI on adherence and attitudes to oral oncology medications, and the impact on health-related quality of life in the older adult with cancer. The advanced practice registered nurse (APRN) applied the MI intervention via telehealth during 3 encounters: 1) baseline, within 1-12 months after starting an oral oncology medication, 2) 2 weeks after the baseline visit, and 3) 4-6 weeks following the initial encounter. Enrolled participants (n=15) were predominantly white, non-Hispanic women with advanced cancer, on multiple oral medications. Five qualitative themes were identified: Access to Medication, Taking the Medication, Side Effects, Psychological Aspects/Coping, and Health-Related Quality of Life. Quantitative data identified: 1) all participants (100%) in the &ldquo;action&rdquo; and &ldquo;maintenance&rdquo; Stages of Change; 2) treatment beliefs and medication-taking behaviors improved with the MI intervention, with little change in attitude, inconvenience, and forgetfulness; 3) physical quality of life remained unchanged; however, mental health quality of life improved over time.</p>