MASCC Oral Agent Teaching Tool (MOATT)

©MASCC, Multinational Association for Supportive Care in Cancer™ •  All rights reserved worldwide.

Download the MOATT

MOATT© Approval: Nonprofit entities (physicians, nurses, etc.) are encouraged to use the MOATT and may do so free of charge. Commercial companies must obtain written approval from MASCC and will incur a nominal fee for using this tool. Please contact the Executive Director for additional information regarding the approval procedure at [email protected].

Translations below
English - MOATT User Guide
English - MOATT v.1.2: PDF / Word Doc

MOATT Card Style Format: Designed for printing double sided on 8.5"x 11" card stock.  This card contains the guidelines, an evaluation section and a cut-off section to be given to the patient.  Depending on your printer's double sided settings, you can use the card-style with both pages right side up or  card-style with second page flipped .  

About the MOATT

The MOATT© contains four sections. The first lists key questions to assess the patient's knowledge of the treatment plan, current medications, and ability to obtain and take an oral cancer agent. The second section contains general patient teaching instructions applicable to all oral cancer agents, such as storage, handling, and disposal, identifying a system for remembering to take the drug, and actions to take for various situations, such as a missed dose. The third section is used to provide drug-specific information, such as dose and schedule, side effects, and potential interactions. The last section lists questions that may be asked to ascertain understanding of the information provided. The MOATT is patent protected and is the property of MASCC. 

The Education Study Group has also developed a User Guidealt that provides an introduction and explanation of how best to take advantage of the MOATT. This User Guide provides background for patient education in general, as well as a framework and examples of the MOATT’s usefulness in clinical and research settings. Use of the MOATT requires written approval, as explained below.

MASCC appreciates the unrestricted grants from Eli Lilly, OSI Pharmaceutical Company, and Celgene Corporation that were used to develop the MOATT.

Translations  - Translation Policy 

Estonian - MOATT v.1.2: PDF / Word Doc
(posted 1/2022)

Italian - MOATT v.1.2: PDF / Word Doc
Translated by: Francesca Gambalunga   (posted 7/2017)

Japanese - MOATT v.1.2: PDF / Word Doc
Translated by: Yuki Nagamatsu and Jennie Knowles   (posted 10/2021)

Persian - MOATT v.1.2: PDF / Word Doc
Translated by: Maryam Rassouli and Maryam Taghizadeh-Gheh  (posted 8/2021)

Portuguese - MOATT v.1.2: PDF / Word Doc
Translated by: Maria José Silva Dias and Maria Graça Silva Braz   (posted 12/2016)

Spanish - MOATT v.1.2: PDF / Word Doc
Translated by: Iris Cirera Perez and Paz Fernandez-Ortega  (posted 2/2017)

Research Using the MOATT

A Structured Nursing Intervention at Dana-Farber Cancer Institute
Jean Boucher and colleagues published the results of a study designed to evaluate a nurse-led intervention using the MOATT with the goals of increasing patient knowledge and adherence to therapy. This was a longitudinal, descriptive, feasibility study conducted in an ambulatory thoracic oncology disease center at the Dana-Farber Cancer Institute in Boston, Massachusetts. Thirty adult patients with lung cancer, who were being treated with the oral agent erlotinib, participated in the study (with 27 completing).

The intervention consisted of structured, nurse-led education sessions using the MOATT, along with a  a 72-hour follow-up telephone contact. Participants completed a Knowledge Rating Scale (KRS) and adapted Morisky Medication Adherence Scale–8 (MMAS-8) at the end of the first cycle of oral chemotherapy. Participants showed high knowledge levels and MMAS-8 scores. They reported a median of two side effects.

The structured education sessions and follow-up monitoring ranged from 14 to 30 minutes. Given the positive results, this intervention appears effective and feasible to integrate into the thoracic oncology setting. This study included no objective measures of treatment adherence, and the authors recommend that this should be done in the future. They also advocate the development of strategies for delivering supportive care to patients at home. 

Preliminary results of this study were presented in an abstract at the 2012 MASCC/ISOO Annual Meeting: Hooper C, Lucca J, Pedulla, LV, Boucher J. Feasibility and Applicability of MASCC Oral Agent Teaching Tool (MOATT©) for Patients with Lung Cancer on Erlotinib. The authors noted that the MOATT© was adaptable for drug-specific application and could be tailored to individual needs. It also facilitated documentation. 

The published study appears in the July 2015 issue of Oncology Nursing Forum: Boucher J, Lucca J, Hooper C, Pedulla L, Berry DL. A Structured Nursing Intervention to Address Oral Chemotherapy Adherence in Patients With Non-Small Cell Lung Cancer. Oncol Nurs Forum 2015 Jul 1;42(4):383-9.


A Structured Nursing Intervention to Address Oral Chemotherapy Adherence in Patients With Non-Small Cell Lung Cancer. Oncology Nursing Forum 2015 Jul 1;42(4):383-9. Boucher J, Lucca J, Hooper C, Pedulla L, Berry DL. 

MASCC Oral Agent Teaching Tool (MOATT): Yesterday, Today and Tomorrow. Canadian Oncology Nursing Journal. 2014 Summer;24(3):207-10. Lemonde, M. [Article in English, French] 

Meeting Educational Needs and Enhancing Adherence of Patients Receiving Oral Cancer Agents Through Use of the MASCC Oral Agent Teaching Tool©European Oncology & Haematology, 2012;8(2):97–100. Rittenberg, CN.

Development of teaching tool for patients receiving oral agents for cancer. Supportive Care in Cancer 2010 May; 18(5):583-590. Kav S,  Nirenberg A,  Schulmeister  L,  Barber L, Johnson J, Rittenberg C.

Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment: an International survey.Supportive Care in Cancer 2008 Sep;16(9):1075-83. Kav S, Barber L, Johnson J, Nirenberg A, Rittenberg C, Schulmeister L.

MOATT ©MASCC, Multinational Association for Supportive Care in Cancer™ •  All rights reserved worldwide.
For Questions or additional information, contact the Executive Director at [email protected].