KU Leuven, Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, O&N 2 Herestraat 49 box 521, 3000, Leuven, Belgium.
KU Leuven, Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, O&N 2 Herestraat 49 box 521, 3000, Leuven, Belgium.
Eur J Oncol Nurs. 2019 Aug;41:173-194. doi: 10.1016/j.ejon.2019.06.010. Epub 2019 Jun 29.
The process of education and counselling of patients treated with oral anticancer drugs, aimed to achieve adequate self-management, involves different stakeholders (i.e. physicians, oncology nurses, pharmacists) from primary and secondary care. However, currently no guiding principles exist on how to organize and perform education and counselling for these patients. Therefore, the purpose of this study was to develop and build consensus on key elements for the education and counselling in patients on oral anticancer drugs.
A multi-method approach combining a literature search, semi-structured interviews with patients and healthcare professionals, and input from experts were used to develop an initial list of key elements. Subsequently, consensus was built in a two-round Delphi-study, involving patients and healthcare professionals from primary and secondary care. Key elements were retained if at least 80% of respondents in all groups considered the element as important or if in at least one group 90% consensus was reached.
The initial list contained 110 key elements, divided in 7 themes: coordination of care, patient contacts: style and content, medication counselling at the start of the treatment and during follow-up, psychosocial support, and involvement of family and friends. After the first Delphi round, 80% consensus was reached for 23 elements; 6 new key elements were added. After the second round, 80% consensus was reached for 51 out of 116 elements; 31 elements were added following the 90%-rule, yielding a list of 82 elements.
The final list of 82 key elements, obtained in this study, could be used to develop clinical pathways that guide adequate education and counselling of patients on oral anticancer drugs. Due to the open description, the implementation of these elements can be adapted to the specific context and composition of the oncology team.
对接受口服抗癌药物治疗的患者进行教育和咨询，目的是实现充分的自我管理，涉及初级和二级保健的不同利益相关者（即医生、肿瘤护士、药剂师）。然而，目前尚不存在关于如何组织和实施这些患者教育和咨询的指导原则。因此，本研究的目的是制定并就口服抗癌药物患者教育和咨询的关键要素达成共识。
采用结合文献检索、半结构式访谈患者和医疗保健专业人员以及专家意见的多方法方法，制定了关键要素的初始清单。随后，在包括初级和二级保健的患者和医疗保健专业人员的两轮 Delphi 研究中建立了共识。如果所有组别的至少 80%的受访者认为该要素重要，或者如果至少有一个组的 90%达成共识，则保留关键要素。
初始清单包含 110 个关键要素，分为 7 个主题：护理协调、患者接触：风格和内容、治疗开始和随访期间的药物咨询、心理社会支持以及家人和朋友的参与。在第一轮 Delphi 研究之后，80%的受访者对 23 个要素达成共识；新增 6 个关键要素。在第二轮之后，80%的受访者对 116 个要素中的 51 个达成共识；根据 90%-规则新增 31 个要素，得出 82 个要素的清单。
本研究获得的最终 82 个关键要素清单可用于制定指导口服抗癌药物患者充分教育和咨询的临床路径。由于描述是开放式的，因此可以根据肿瘤团队的特定情况和组成来实施这些要素。
