I know myself there has been occasion that I have missed a dose of medication(not chemotherapy) and really didn't want to admit that I had missed a dose. I am sure that I am not alone in this and therefore the concerns for the patient that is administering their own chemotherapy and reporting side effects, problems, concerns and compliance comes to the forefront. It is hard as a healthcare provider to know what is happening for the patient receiving the oral chemotherapy unless they contact us with their issues. It may be necessary at the front end to try to identify those patients that may be at risk for nonadherence. The fact that these patients are further isolated from the healthcare provider adds another dimension to what may or may not be a successful outcome. It is important to fully examine what patients qualify for oral treatment. Not only does the patient have to be proactive but also the nurse to help build a partnership for successful
With all the new things that are coming out in treating cancer, one thing we are hearing more of is oral chemotherapy and moving away from IV chemotherapy. Many patients prefer oral to IV therapy and I can totally get on board with that thought but from the medical standpoint, the nurse will have less contact with patients . There is also a misconception that since it is oral rather than IV that the medication is less toxic. There remains serious complications or consequences if oral chemotherapy is not closely adhered to how it was prescribed. There could be serious outcomes. The other outstanding issues is the fact that when you are monitoring your own medications, how compliant are you and are you adhering to how it was to be administered? The advantage of having an oral chemotherapeutic agent is pretty self explanitory as it gives you more freedom and less interruption in your daily life and activities if we are administering it as prescribed and the patient is taking it as directed. Education is often directly received by the pharmacists or physician and thus the nurse may have less contact with the patient and increaseing the responsibility of the patient in their own care. It is important to healthcare providers to have an ongoing relationship with the patient and the need remains: to address the patients needs and assess potential areas to improve compliance for patients using oral chemotherapeutics. Patients are going to have to become proactive in their care duing their treatment.
I know myself there has been occasion that I have missed a dose of medication(not chemotherapy) and really didn't want to admit that I had missed a dose. I am sure that I am not alone in this and therefore the concerns for the patient that is administering their own chemotherapy and reporting side effects, problems, concerns and compliance comes to the forefront. It is hard as a healthcare provider to know what is happening for the patient receiving the oral chemotherapy unless they contact us with their issues. It may be necessary at the front end to try to identify those patients that may be at risk for nonadherence. The fact that these patients are further isolated from the healthcare provider adds another dimension to what may or may not be a successful outcome. It is important to fully examine what patients qualify for oral treatment. Not only does the patient have to be proactive but also the nurse to help build a partnership for successful
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AuthorMy name is Sue Kilburn and I am a clinical nurse breast cancer educator at the Yolanda G. Barco Oncology Institute in Meadville, Pennsylvania. Archives
March 2015
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