Effects of individualized nurse-led care plans on olaparib treatment duration.

Abstract

Objective: To assess the effects of a nurse-led personalized care plan on the duration of olaparib therapy among patients with cancer.

Study design: Cohort study conducted from January 2020 to June 2022.

Methods: Data from an independent specialty pharmacy were used to identify patients 18 years and older with at least 1 olaparib (Lynparza) prescription who were at high risk for olaparib nonadherence as assessed using a pharmacy intake survey. We compared olaparib therapy duration between patients with and without a nurse-led personalized care plan. Multivariable Cox proportional hazards regression was used to estimate adjusted HRs (aHRs) for therapy discontinuation.

Results: Of 560 patients at high risk for olaparib nonadherence, 163 received a care plan and 397 did not. Commonly reported symptoms included fatigue, nausea, gastrointestinal tract problems, depression, anxiety, and pain. The care plan group had significantly longer olaparib therapy (median [IQR], 6.7 [2.5-14.3] months vs 4.9 [1.9-10.4] months; P < .001) and a lower risk of discontinuing treatment (aHR, 0.77; 95% CI, 0.64-0.94) than the controls. Within the care plan group, patients experiencing resolution of at least 1 symptom (median therapy duration [IQR], 10.3 [4.8-19.0] months vs 3.9 [1.9-11.4] months; P < .001) or at least 1 dose modification (median therapy duration [IQR], 11.9 [6.7-17.8] months vs 4.7 [1.9-11.8] months; P < .001) had approximately 2.5 times longer olaparib therapy duration than patients who did not.

Conclusions: A nurse-led personalized care approach effectively increased medication persistence among patients receiving olaparib for treatment of cancer, and the effect was more apparent among care plan patients who experienced symptom resolution or dose modification.