This study aims to conduct a scoping review of research related to oral chemotherapy drug adherence in cancer patients, providing a reference for the development of standardized intervention protocols for cancer patients. Based on the scoping review framework proposed by Arksey and O'Malley, we systematically searched eight databases up to December 1, 2024, according to three research questions, and conducted screening and information extraction. A total of 22 studies were included. Most interventions are based on assessment, education, monitoring, and follow-up, primarily led by nurses, pharmacists, or multidisciplinary teams. Intervention content includes core knowledge such as medication administration methods, identification and management of side effects, and self-management strategies, supplemented by behavioral support and psychological adjustment techniques. Outcome evaluation indicators primarily include questionnaire or self-report tools to assess behavioral changes, supplemented by objective monitoring data on adherence rates. Although there has been an increase in intervention studies on oral chemotherapy medication adherence, few have undergone rigorous validation, and there is a lack of interventions tailored to the needs of different patient populations. It is recommended that future research be based on appropriate theoretical models to develop strategies to improve adherence and explain the underlying mechanisms. Digital interventions offer a new direction for improving oral chemotherapy adherence, particularly for elderly home-dwelling patients. However, their effectiveness depends on technical design and patient acceptance. Therefore, future efforts should focus on developing humanized, elderly-friendly smart care systems, optimizing the specific content of intervention programs, conducting high-quality research, and promoting improved medication adherence to enhance patients' self-management capabilities.

Nina Xie, Yuping Xiao, Ruimei Jia, Yang Liu, Xixi Zhang, Yu Zhang. Adherence to Oral Chemotherapy Agents in Oncology Patients: A Scoping Review. Academic Journal of Medicine & Health Sciences (2025), Vol. 6, Issue 6: 16-23. https://doi.org/10.25236/AJMHS.2025.060603.

[1] Jacobs JM, Pensak NA, Sporn NJ, et al. Treatment Satisfaction and Adherence to Oral Chemotherapy in Patients With Cancer. J Oncol Pract. 2017;13(5):e474-e485. doi:10. 1200/JOP. 2016. 019729

[2] Khandelwal N, Duncan I, Ahmed T, Rubinstein E, Pegus C. Oral chemotherapy program improves adherence and reduces medication wastage and hospital admissions. J Natl Compr Canc Netw. 2012;10(5):618-625. doi:10.6004/jnccn.2012.0063

[3] Krolop L, Ko YD, Schwindt PF, Schumacher C, Fimmers R, Jaehde U. Adherence management for patients with cancer taking capecitabine: a prospective two-arm cohort study. BMJ Open. 2013; 3(7): e003139. Published 2013 Jul 19. doi:10.1136/bmjopen-2013-003139

[4] Haider I, Pond GR, Cameron R, et al. A structured oral chemotherapy teaching tool to improve adherence in adults with multiple myeloma: A pilot randomized controlled trial. J Geriatr Oncol. 2024; 15(3):101735. doi:10.1016/j.jgo.2024.101735

[5] Greer JA, Amoyal N, Nisotel L, et al. A Systematic Review of Adherence to Oral Antineoplastic Therapies. Oncologist. 2016;21(3):354-376. doi:10.1634/theoncologist.2015-0405

[6] Dang TH, Wickramasinghe N, Jayaraman PP, et al. Digital Solution to Support Medication Adherence and Self-Management in Patients with Cancer (SAMSON): Pilot Randomized Controlled Trial. JMIR Form Res. 2025;9:e65302. Published 2025 Feb 19. doi:10.2196/65302

[7] McCue DA, Lohr LK, Pick AM. Improving adherence to oral cancer therapy in clinical practice. Pharmacotherapy. 2014;34(5):481-494. doi:10.1002/phar.1399

[8] Mislang AR, Wildes TM, Kanesvaran R, et al. Adherence to oral cancer therapy in older adults: The International Society of Geriatric Oncology (SIOG) taskforce recommendations. Cancer Treat Rev. 2017;57:58-66. doi:10.1016/j.ctrv.2017.05.002

[9] Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005; 8(1). DOI: 10.1080/1364557032000119616 

[10] Lau-Min KS, Marini J, Shah NK, et al. Pilot Study of a Mobile Phone Chatbot for Medication Adherence and Toxicity Management Among Patients With GI Cancers on Capecitabine. JCO Oncol Pract. 2024;20(4):483-490. doi:10.1200/OP.23.00365

[11] McGrady ME, Ketterl TG, Webster RT, et al. Feasibility pilot trial of a tailored medication adherence-promotion intervention for adolescents and young adults with cancer: Study design and protocol. Contemp Clin Trials. 2024;139:107483. doi:10.1016/j.cct.2024.107483

[12] Schneider SM, Adams DB, Gosselin T. A tailored nurse coaching intervention for oral chemotherapy adherence. J Adv Pract Oncol. 2014;5(3):163-172

[13] Spoelstra SL, Given BA, Given CW, et al. An intervention to improve adherence and management of symptoms for patients prescribed oral chemotherapy agents: an exploratory study. Cancer Nurs. 2013;36(1):18-28. doi:10.1097/NCC.0b013e3182551587

[14] Sommers RM, Miller K, Berry DL. Feasibility pilot on medication adherence and knowledge in ambulatory patients with gastrointestinal cancer. Oncol Nurs Forum. 2012;39(4):E373-E379. doi:10. 1188/12. ONF.E373-E379

[15] Partridge AH, Archer L, Kornblith AB, et al. Adherence and persistence with oral adjuvant chemotherapy in older women with early-stage breast cancer in CALGB 49907: adherence companion study 60104. J Clin Oncol. 2010;28(14):2418-2422. doi:10.1200/JCO.2009.26.4671

[16] Decker V, Spoelstra S, Miezo E, et al. A pilot study of an automated voice response system and nursing intervention to monitor adherence to oral chemotherapy agents. Cancer Nurs. 2009;32(6):E20-E29. doi:10.1097/NCC.0b013e3181b31114

[17] Li Y, Chen J. Effect of integrated continuous nursing on adherence to oral chemotherapy at home in patients with gastrointestinal tumors[J]. Journal of Practical Gynecologic Endocrinology (Electronic Edition), 2018. DOI: CNKI:SUN:FKDZ.0.2018-35-096

[18] Sun Juanhua, Huang Ying, Zhang Hongmei, et al. Analysis of systematic management to improve oral chemotherapy adherence among cancer patients outside the hospital[J]. Chinese Journal of Cancer Prevention and Treatment, 2016(S1):2. DOI: CNKI:SUN:QLZL.0.2016-S1-179

[19] Campbell C. Nursing intervention to improve adherence and safety with oral cancer therapy. Can Oncol Nurs J. 2014;24(4)

[20] Başoğlu S, Polat Ü. The Effect of Education and Monitoring via Tele-Nursing to Elderly Cancer Patients Using Oral Anticancer Agents on Self-efficacy and Medication Adherence: A Randomized Controlled Trial. Semin Oncol Nurs. 2024;40(5):151692. doi:10.1016/j.soncn.2024.151692

[21] Gönderen Çakmak HS, Kapucu S. The Effect of Educational Follow-Up with the Motivational Interview Technique on Self-Efficacy and Drug Adherence in Cancer Patients Using Oral Chemotherapy Treatment: A Randomized Controlled Trial. Semin Oncol Nurs. 2021;37(2):151140. doi:10.1016/j. soncn. 2021.151140

[22] Tokdemir G, Kav S. The Effect of Structured Education to Patients Receiving Oral Agents for Cancer Treatment on Medication Adherence and Self-efficacy. Asia Pac J Oncol Nurs. 2017;4(4):290-298. doi:10.4103/apjon.apjon_35_17

[23] Vacher L, Thivat E, Poirier C, et al. Improvement in adherence to Capecitabine and Lapatinib by way of a therapeutic education program. Support Care Cancer. 2020;28(7):3313-3322. doi:10. 1007/s00520-019-05144-x

[24] Eldeib HK, Abbassi MM, Hussein MM, Salem SE, Sabry NA. The Effect of Telephone-Based Follow-Up on Adherence, Efficacy, and Toxicity of Oral Capecitabine-Based Chemotherapy. Telemed J E Health.2019;25(6):462-470. doi:10.1089/tmj.2018.0077

[25] Komatsu H, Yagasaki K, Yamaguchi T, et al. Effects of a nurse-led medication self-management programme in women with oral treatments for metastatic breast cancer: A mixed-method randomised controlled trial. Eur J Oncol Nurs. 2020;47:101780. doi:10.1016/j.ejon.2020.101780

[26] Dang TH, Wickramasinghe N, Jayaraman PP, et al. Safety and adherence to medications and self-care advice in oncology (SAMSON): pilot randomised controlled trial protocol. BMJ Open. 2024;14(7):e079122. Published 2024 Jul 23. doi:10.1136/bmjopen-2023-079122

[27] Cheng C, Ho RTH, Guo Y, et al. Development and Feasibility of a Mobile Health-Supported Comprehensive Intervention Model (CIMmH) for Improving the Quality of Life of Patients With Esophageal Cancer After Esophagectomy: Prospective, Single-Arm, Nonrandomized Pilot Study. J Med Internet Res. 2020;22(8):e18946. Published 2020 Aug 18. doi:10.2196/18946

[28] Arthurs G, Simpson J, Brown A, Kyaw O, Shyrier S, Concert CM. The effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients in ambulatory care settings: a systematic review. JBI Database System Rev Implement Rep. 2015;13(5):244-292. Published 2015 Jun 12. doi:10.11124/jbisrir-2015-2057

[29] Muluneh B, Upchurch M, Mackler E, et al. Optimizing Adherence to Oral Anticancer Agents: Results from an Implementation Mapping Study.Curr Oncol. 2025;32(2):78. Published 2025 Jan 29. doi:10.3390/curroncol32020078

[30] Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N. Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005; 58(2):107-112. doi:10.1016/j.jclinepi.2004.09.002

[31] Kwasnicka D, Dombrowski SU, White M, Sniehotta F. Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories. Health Psychol Rev. 2016; 10(3):277-296. doi:10.1080/17437199.2016.1151372

[32] Peh KQE, Kwan YH, Goh H, et al. An adaptable framework for factors contributing to medication adherence: results from a systematic review of 102 conceptual frameworks. J Gen Intern Med. 2021; 36(9):2784–2795.