Knowing, Doing and Disclosing: An Ethnography of Communication Processes Involving the Safe Management of Oral Chemotherapy

Introduction:
The use and prescription of oral chemotherapeutic medications is growing with several new oral drugs in development. While there are numerous benefits associated with the use of oral chemotherapy, there are several risks to which a patient must be comprehensibly informed. The aim of this study was to examine how patients received, understood and acted upon healthcare professional education about their oral chemotherapeutic regimen throughout their treatment.
Methods:
Over 60 hours of observational data were digitally recorded from interactions between 9 oncology doctors, 6 oncology nurses, 8 patients and 11 family members over a period of six months in outpatient departments within one hospital in Northern Ireland. Sixteen semi-structured interviews were conducted with patients during and after their treatment. Three focus-groups were carried out with health care professionals at the end of the study. Information leaflets given to patients were also examined. Data was thematically analysed.
Results:
The three themes of knowing, doing and disclosing emerged with regards to communication processes about safe management of oral chemotherapy. These themes related to patient/family understanding about oral chemotherapy (knowing), oral chemotherapy medication-taking practice (doing) and patient/family management and reporting of chemotherapy risks and side-effects (disclosing).
Conclusions:
There is a prominence of non-personalised education for people in receipt of oral chemotherapeutic treatment. This approach was not detrimental to patient safety in this study, however it did lead to patients having unmet needs regarding appropriate oral chemotherapy adherence, reporting of side-effects and long-term sequalae of treatment.