Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden.
Division of Pediatrics, Karolinska University Hospital, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
J Oncol Pharm Pract. 2023 Jun;29(4):818-825. doi: 10.1177/10781552221080445. Epub 2022 Feb 14.
Long term treatment of pediatric patients with oral anticancer drugs (OADs) requires the parents/caregivers to prepare the drug at home. The handling procedures in the home setting are, however, not regulated by Swedish law and the parents are often left without guidance on how to handle OADs in a safe way.
The aim of this study was to increase understanding of how OADs are handled by parents/caregivers in the home setting before and after an intervention.
Parents of pediatric cancer patients were observed and videotaped during their handling of OADs in the home setting before and after the intervention. During the intervention, the parents were provided with written instructions, movie clips and practical training on handling the OADs. Four checklists were used to compare and score the four handling procedures (measuring an oral suspension, cutting tablets, dissolving tablets, and opening capsules) for each parent before and after the intervention.
The intervention significantly improved the OAD handling procedures among the studied parents. The median score for correct handling was 19% (IQR: 3.6 to 30%) before the intervention and 89.5% (IQR: 71.5 to 94.5%) after the intervention (p < 0.0001).
An intervention comprising practical training and information presented in different forms improved the handling of OADs at home by parents. There is an urgent need to implement this method in all oncology centers in Sweden, educate HCPs to standardize the presentation of information. There is also a great need to provide parents with age-appropriate oral drug formulations from the local hospital pharmacies in Sweden.
长期为接受口服抗癌药物（OAD）治疗的儿科患者提供药物需要家长/护理人员在家中准备药物。然而，家庭环境中的处理程序不受瑞典法律监管，家长通常得不到有关如何安全处理 OAD 的指导。
本研究旨在提高对家长在家中处理 OAD 前后的处理方式的理解。
在干预前后，观察并记录接受儿科癌症治疗的儿童的家长在家中处理 OAD 的情况。在干预期间，向家长提供书面说明、电影剪辑和处理 OAD 的实践培训。使用四个清单比较并评分每个家长在干预前后进行的四项处理程序（测量口服混悬剂、切割片剂、溶解片剂和打开胶囊）。
干预显著改善了研究中家长的 OAD 处理程序。干预前正确处理的中位数评分为 19%（IQR：3.6 至 30%），干预后为 89.5%（IQR：71.5 至 94.5%）（p<0.0001）。
包括实践培训和以不同形式呈现信息的干预措施改善了家长在家中处理 OAD 的方式。迫切需要在瑞典所有肿瘤中心实施这种方法，教育卫生保健专业人员以标准化信息的呈现方式。还迫切需要为瑞典当地医院药房的家长提供适合年龄的口服药物制剂。
