scholarly journals Medication Experience and Adherence to Oral Chemotherapy: A Qualitative Study of Patients’ and Health Professionals’ Perspectives

Author(s):  
Amparo Talens ◽  
Mercedes Guilabert ◽  
Blanca Lumbreras ◽  
María Teresa Aznar ◽  
Elsa López-Pintor

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients’ experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in treatment with ANEO, to describe the barriers and facilitators related to the disease and its treatment and to compare them with the healthcare professionals’ perspectives. We carried out an exploratory qualitative study in the University Hospital of San Juan de Alicante, Spain. Three focus groups and two nominal group discussions were conducted with 23 onco-hematological patients treated with ANEO and 18 health professionals, respectively. The data were analyzed using content analyses and were eventually triangulated. The most impactful aspects in patients’ ME were the presence of adverse effects; lack of information about treatment; beliefs, needs and expectations regarding medications; social and family support; and the relationship with the health professionals. Both patients and professionals agreed on considering the negative side effects and the information about treatment as the main barriers and facilitators of adherence, respectively, although the approaches differed between both profiles. The professionals offered a more technical vision while patients prioritized the emotional burden and motivation associated with the disease and medication. This study allowed us to understand the real-life experiences of patients being treated with ANEO and explore the factors which had an impact on adherence to treatment. This understanding enables professionals to have a positive influence on patients’ behavior and provide individualized care plans. Pharmacists’ assistance is relevant to support patients’ adherence and self-management.

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023603 ◽  
Author(s):  
Mohammed Ibrahim Aladul ◽  
Raymond William Fitzpatrick ◽  
Stephen Robert Chapman

ObjectiveTo investigate UK healthcare professionals’ perceptions and perspectives towards biosimilar infliximab, etanercept and insulin glargine and the potential barriers and facilitators to their prescribing.DesignA cross-sectional qualitative study design was used.SettingFive hospitals within the West Midlands area in UK.Interventions30 min face-to-face, semistructured interviews of healthcare professionals.Participants22 healthcare professionals (consultants, nurses and pharmacists) participated in the semistructured interviews.OutcomesParticipants’ opinion and attitudes about biosimilars and the barriers and facilitators to the prescribing of infliximab, etanercept and insulin glargine biosimilars in gastroenterology, rheumatology and diabetology specialties.ResultsThis study showed that UK healthcare professionals had good knowledge of biosimilars and were content to initiate them. Healthcare professionals disagreed with biosimilar auto-substitution at pharmacy level and multiple switching. Subtle differences among healthcare professionals were identified in the acceptance of switching stable patients, indication extrapolation and cost savings sharing.ConclusionSafety and efficacy concerns, patients’ opinion and how cost savings were shared were the identified barriers to considering prescribing biosimilars. Real-life data and financial incentives were the suggested facilitators to increase biosimilar utilisation.


2020 ◽  
Vol 13 (3) ◽  
pp. 125-139
Author(s):  
Gijs Hesselink ◽  
Merlijn Smits ◽  
Mariël Doedens ◽  
Sharon M. T. Nijenhuis ◽  
Denise van Bavel ◽  
...  

Objectives: Gaining an understanding of postoperative patients’ environmental needs, barriers, and facilitators for optimal healing. Background: An optimal hospital environment (the “healing environment”) can enhance patients’ postoperative recovery and shorten length of stay. However, insights lack into patients’ lived environmental needs for optimal healing after surgery and how these needs are being met. Method: A qualitative study was conducted between August 2016 and August 2017 with 21 patients who underwent elective major abdominal surgery in a Dutch university hospital. Data were collected through context-mapping exercises and interviews to capture patients’ lived experiences and explore the meaning of these experiences. Data were systematically analyzed according to the principles of thematic content analysis. Results: Three themes were identified. First, participants want a sense of control over their treatment, ambient features, privacy, nutrition, and help requests. Participants described the need for positive distractions: personalizing the room, connecting with the external environment, and the ability to undertake activities. Finally, participants expressed the importance of functional, practical, and emotional support from professionals, peers, and relatives. According to participants, the hospital environment often does not meet their healing needs while being hospitalized. Conclusion: The hospital environment often does not meet patients’ needs. Needs fulfillment can be improved by practical adjustments to the physical and interpersonal environment and considering patient’s individual preferences and changing needs during recovery. Patient narratives, pictures, and drawings are valuable sources for hospital managers in their efforts to design evidence-based environments that anticipate to patient-specific needs for achieving early recovery.


Trials ◽  
2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Jo Rick ◽  
Mike Clarke ◽  
Alan A. Montgomery ◽  
Paul Brocklehurst ◽  
Rachel Evans ◽  
...  

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