The pilot project “Patient communication in oral tumor therapy to promote adherence” will evaluate whether targeted communication training for nurses and physicians adds value for patients and the healthcare professionals involved. Initial results now show that participants not only receive new impetus and tools via such workshops to improve therapy adherence through targeted discussions with patients, but also learn how to explain the mode of action of the drugs and the expected side effects well.
Oral antitumor drugs and their practical use have developed rapidly over the past decade. This situation poses previously unknown problems and new challenges for physicians and nurses, because the shift of responsibility from physicians and nurses to patients with regard to taking medications and the discontinuation of regular checks by specialists can have a considerable impact on patient adherence. However, the success of oral tumor therapy is largely dependent on patient adherence. This should therefore be promoted in a targeted and permanent manner through optimal patient management.
Lack of therapy adherence: relevant issue in oral tumor therapy
The term adherence describes the patient’s own responsibility to adhere to the given, medical treatment plan in order to achieve the desired treatment goal. Adherence aims at a kind of contract between doctor and patient. The opposite of this is non-adherence, where there is deviation from the treatment plan and agreements. Non-adherence cannot be attributed or even generalized to factors such as age, gender, ethnicity, education level, social status or disease situation. In contrast, other factors such as treatment complexity or adverse effects strongly influence non-adherence (Table 1) [1].
Lack of treatment adherence and non-adherence are relevant issues in oncology precisely because of these factors. This was also evident from the first survey conducted as part of the pilot project “Patient Communication in Oral Tumor Therapy to Promote Adherence” among participants of communication workshops for nurses or for physicians. Thus, the vast majority stated that they encountered the problem of poor adherence in their daily lives sometimes to frequently.
Inevitable to adherence improvement: patient communication.
The treatment team significantly influences the patient’s adherence to therapy. Central to adherence-promoting measures is constant communication. Information, training, and personal counseling play a central role [1]. To address this, the pilot project “Patient Communication in Oral Tumor Therapy to Promote Adherence” focuses on teaching tools for communication in the form of specific communication workshops for nurses and physicians. A survey will be used to evaluate whether targeted training adds value for patients and the professionals involved. Within the framework of the workshops, appropriate tools for targeted patient communication that have been proven in practice are taught and their correct use is trained (Tab. 2).
First results
Initial surveys of the pilot project among participating physicians and nurses revealed a consistent positive response: all respondents indicated that they had received new tools through the workshop to better address treatment adherence with patients.
Six weeks after the initial survey, 78% of nurses reported being better or partially better able to respond to patients and their needs as a result of the tools and exercises from the workshop. This value remained at 78% even after another six weeks. Two-thirds of respondents reported after six weeks that they were able to at least partially improve their patients’ adherence to therapy through targeted discussions. After another six weeks, this percentage was over 50%. Importantly, more than half of the workshop participants were also able to better address how medications work, expected side effects, and problems after receiving targeted education.
Results of the survey of physicians are not yet fully available at the moment.
Literature:
- Rothermundt C, et al: Adherence and safety in oral tumor therapy. Schweiz Med Forum 2001; 11(15): 276-278.
- Prof. Dr. Alexander Kiss: Presentation 2013: Communication to promote adherence (not published).
InFo Oncology & Hematology 2013; 1(1): 5-6.
