Dados do Resumo

Título

NURSE NAVIGATOR ASSESSMENT OF ADHERENCE TO ORAL DRUG THERAPY IN PATIENTS UNDERGOING ALLOGENEIC BONE MARROW TRANSPLANTATION: AN EXPERIENCE REPORT

Introdução

Approximately 50,000 people undergo hematopoietic cell transplantation worldwide each year. Patients undergoing an allogeneic bone marrow transplant receive an extensive prescription of oral medications at discharge, such as immunosuppressants and prophylactic drugs. Adherence to these medications is crucial to minimize complications such as graft-versus-host disease and infections. Studies have shown a decline in medication adherence over time in post-bone marrow transplant patients. In this context, the nurse navigator is the professional with clinical knowledge in oncology responsible for coordinating the patient's journey. Among their competencies: ensuring continuity of care, boosting adherence to therapy through educational actions, helping to eliminate biopsychosocial barriers and empowering the patient. Studies show that monitoring by a nurse navigator improves the patient's experience and adherence to the therapeutic plan. Considering the intense regimen of drugs prescribed at hospital discharge, the nurse navigator identified the need for a multidimensional intervention capable of monitoring adherence to the post-transplant patient's therapeutic plan.

Objetivo

To report on the experience of the nurse navigator in implementing an assessment of oral medication adherence and the therapeutic plan in patients undergoing allogeneic bone marrow transplantation.

Métodos

Experience report. In 2023, the service carried out 40 allogeneic transplants, of which 43% (17 - private, health insurance and human resources, all of them accompanied by a nurse navigator with expertise in oncohematology.

Resultados

It was decided that all patients would be assessed for their cognitive and physical ability to adhere to oral therapy before undergoing transplantation. In the service we have an instrument already applied to cancer patients, in which barriers to non-adherence are identified at the start of therapy. A brainstorming session was held with the navigation, quality and data management teams to develop an instrument with open and closed questions for evaluation by the nurse navigator, to be applied weekly to patients up to D+30 and fortnightly up to D+100. The nurse evaluates all the medicines in use, checking dosage, periodicity and adherence. In the questionnaire, factors such as food acceptance and complaints that may influence adherence are assessed, and the results are discussed weekly with the multidisciplinary team for adjustments and interventions in the therapeutic plan.

Conclusões

The implementation of medication adherence monitoring by the nurse navigator brings benefits such as a reduction in complications and a better patient experience. As a future action, we will start collecting data using the instrument developed to measure medication adherence in patients undergoing allogeneic transplantation.