Assess Factors that Influence Adherence |
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Patient-related factors |
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Therapy-related factors |
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Complex regimen
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Understanding of medication pharmacology (Missing doses decreases efficacy)
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Understanding medications schedule (time of day to take medicine, take with/without food; medication calendar)
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Fear of safe handling
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Advantages and responsibilities of oral chemotherapy agents
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Safe Handling (wear gloves, don’t crush pills)
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Refill issues
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Side effects
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Side effect management strategies
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Profile sheets for each medication with side effects and management strategies
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1) Side effect management sheet for _________
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2) Side effect management sheet for _________
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3) Side effect management sheet for _________
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Other:
Social/economic factors
Other
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Clinical-related factors |
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Behavioral/Reminder Strategies |
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Medication reminder box (alarmed Y/N) |
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Event reminders (ie, take medications together, take with meals) |
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Set up medications daily/weekly/plans for travel |
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Have caregiver remind you to take medication |
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Medication calendar with check offs |
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Alarm systems (kitchen timer, bedside alarm) |
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Phone alarms |
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Other: |
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Provider Support and Surveillance Strategies |
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Nurse phone calls weekly |
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Have caregiver double check medication box |
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Congratulations with refill |
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Refill reminder post card |
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Notify caregiver of patient concerns, ask provider to reinforce |
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Phone call to support person |
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Referral to counselor |
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Referral to support group |
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Referral to patient assistance program (financial support) |
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Other: |
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