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Exploring the education and information needs of patients on oral anticancer medications

Winner of the Irish Association of Nurses in Oncology; Presidents Prize, March 2014.

Terry Hanan*/ Louise Mullen*/ Orla Walsh*

*NCCP 

March 2014

Aim

Our study examined the information and education needs of patients taking oral anticancer medicines (OAMs) from the perspectives of patients themselves, pharmacists and medical oncology personnel.

Rationale for Research

The use of OAMs is increasing. There is a move away from chemotherapy infusions delivered in hospitals to patients taking oral medications at home. This results in some shift in responsibility from health professionals to patients and caregivers 1. The use of OAMs will double over the coming years. 2 Therefore the safe use of OAMs is critical. In this regard it is essential to identify patient information and education needs.

Methodology

This qualitative study was undertaken in a Dublin cancer centre using:

  • Semi-structured interviews (20 patients)
  • Telephone interviews (5 community pharmacists)
  • Medical oncology personnel focus group.

Results

A thematic analysis of the transcripts highlighted important safety factors from patient, pharmacist and oncology personnel perspectives. The most important factors were:

  • For patients and pharmacists: oral and written information; 24 hour oncology team contact details;
  • For patients: being accompanied at consultations and establishing a routine in taking OAMs
  • For pharmacists: reiterating key safety messages to patients on taking OAMs
  • For medical oncology personnel: interdisciplinary management of OAMs, dedicated clinics and an OAM checklist.

Discussion

The NCCP Oncology Medication Safety Review showed that a diversity, and sometimes absence, of processes in managing OAMs3.  As they are as toxic as IV equivalents, patients need to know about potential side-effects and their management. Compliance with prescribed regimens is essential. This study will inform the development of national guidelines on the information and education needs of patients taking OAM’s. It will contribute to patient safety and fulfil a key recommendation of the Strategy and Educational Framework for Nurses caring for people with cancer in Ireland.

1. Winegart et al (2008) NCCN Task Force Report: Oral Chemotherapy Journal of the National Comprehensive Cancer Network Volume 6 Supplement 3

2. Moody and Jackowski (2010) Are patients on oral chemotherapy in your practice setting safe? Clinical Journal of Oncology Nursing Volume 14, Number 3

3. Heckmann et al (2014) NCCP Oncology Medication Safety Review

4. Hanan T. Laffoy M. Wynne M.  (2012)  A Strategy and Educational Framework for Nurses caring for people with cancer in Ireland