Although patients frequently express a preference for oral medications, compliance to these medications varies. Patients often have difficulty adhering to their medication schedules due to lack of understanding, inadequate support, or unwelcome side effects. Fostering adherence to oral chemotherapy regimens improves patients' chance of survival and long-term quality of life. This randomized trial tested the effectiveness of a tailored intervention to promote adherence to oral chemotherapeutic agents in 45 adult patients with cancer. The control group received the standard chemotherapy education provided at the cancer center. The intervention group received standard education and a tailored adherence plan developed by an advanced practice nurse. The nurse coaching intervention was administered via telephone. Adherence was measured using self-report and pharmacy refill rates. For adherence measures at both 2 and 4 months, the intervention group adherence rates were superior to the control group rates. Pharmacy refill rates of adherence were lower than self-reports. Results suggest that for some participants, the tailored coaching intervention was bene-ficial. Barriers to and facilitators of better adherence are discussed.