School of Nursing


Doctor of Nursing Practice (DNP)


Ken Thompson


Adherence, Medication, Barriers, Screening, Cancer, Comorbidities, Instrument, WBMA


Medicine and Health Sciences | Nursing


Adherence to a prescribed medication regimen is often critical to successful disease management. Cancer diagnoses often further complicate control of the comorbid diseases. Older cancer patients with multiple comorbidities receiving chemotherapy treatment are at increased risk for adverse health outcomes from uncontrolled disease when nonadherent to their medication regimen. The intent of this pilot study was to test the validity of an evidence-based screening instrument designed to identify patients at risk for medication nonadherence and uncontrolled illness. The W-BMA (Washburn-Barrier to Medication Adherence) screening criteria were applied to retrospective data of cancer patients with multiple co-morbidities. SPSS was used to analyze the data using classification trees to compare the W-BMA screen with the current screens used in the clinic alone. The W-BMA identified a significantly larger number of patients with barriers than the current screens alone. Barriers found by the W-BMA screening instrument are strongly related to uncontrolled illness, and, these barriers are often multi-layered, impacting adherence and the health of the patient. Incidentally, there was strong evidence that patients who have barriers addressed by oncology support services (nurse navigation and social work) often fare much better than patients who do not. The instrument studied in this pilot project requires additional analysis and refinement, however, there is strong evidence that proper use of the W-BMA screening instrument used as part of a comprehensive medication adherence program may improve adherence and lower risk of uncontrolled illness and adverse events.

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