Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


School of Nursing



Date of Original Version



As patients begin to receive more oral chemotherapies in the place of the traditional parenteral therapies, the responsibility for treatment falls on the shoulders of patients and their caregivers. The responsibility for the “five rights” of medication administration, which include the- right drug, right dose, right time, right route, and right patient are being transferred to patients and care givers. This places patients at risk for medications errors. Patients and care providers assume responsibility for medication administration, often with little or no healthcare education. As the number of patients being prescribed chemotherapies continues to increase, an emphasis on education as well as adherence to therapy should be emphasized. Multiple barriers exist, that negatively affect a people’s ability to adhere with prescribed treatment. A systematic review was conducted to identify the most prevalent barriers to nonadherence in this patient population. The Preferred Reporting Items for Systematic Reviews (PRISMA) checklist and flowchart were utilized to extrapolate, analyze, and synthesize the date. Common themes were identified and organized into three main categories: patient-related factors, system-related factors, and nurse and provider-related factors. The most prevalent were analyzed in further detail which revealed there were multi-factorial causes of nonadherence to oral chemotherapies. Under the patient-related heading, adverse effects and toxicities as well as forgetfulness were seen most commonly in the literature. Within the theme of systemrelated both regimen complexity and financial causes were found, whereas under nurse and provider-related patient education and frequency and length of follow up were most common. The advanced practice nurse (APN) is in the prime position to help counter-act these barriers to adherence. This systematic review served to help identify common causes of nonadherence to patients’ oral chemotherapeutic agents as prescribed.

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