Moore Susan
MCG Oncology, Chicago, IL, USA.
Clin J Oncol Nurs. 2010 Feb;14(1):41-7. doi: 10.1188/10.CJON.41-47.
Adherence is a potentially significant issue in oral therapy for breast cancer. Suboptimal adherence to medication regimens impacts clinical benefit and can result in treatment resistance, disease progression, and even death. Nonadherence is a greater issue with oral medications because the majority of responsibility shifts from healthcare professionals to the patient. Improving adherence to medication regimens can impact patients' likelihood of successful clinical outcomes. Many factors contribute to adherence behavior, such as complex dosing or administration requirements, cost, and a lack of understanding of the importance of adherence. Most of the factors are controlled by the patient, but nurses can play a significant role by monitoring patients, identifying potential barriers to adherence, and implementing intervention strategies. If barriers to adherence with oral therapies cannot be overcome, the use of IV therapies with equivalent efficacy and acceptable safety should be considered. Using IV medication, when available, can improve outcomes by ensuring that the patient receives the correct and optimal dose of medication at every cycle.
依从性是乳腺癌口服治疗中一个潜在的重要问题。对药物治疗方案的依从性欠佳会影响临床疗效，并可能导致治疗抵抗、疾病进展甚至死亡。口服药物的不依从问题更为突出，因为大部分责任从医护人员转移到了患者身上。提高对药物治疗方案的依从性会影响患者获得成功临床结局的可能性。许多因素会影响依从行为，例如复杂的给药或用药要求、费用以及对依从性重要性的认识不足。大多数因素由患者控制，但护士可通过监测患者、识别依从性的潜在障碍并实施干预策略发挥重要作用。如果无法克服口服治疗的依从性障碍，则应考虑使用疗效相当且安全性可接受的静脉治疗。如有静脉用药，使用静脉用药可通过确保患者在每个周期都能接受正确且最佳剂量的药物来改善治疗效果。
