Patients with non-small cell lung cancer may benefit from pills to take at home once or twice a day to inhibit the growth of cancer cells. It is nice for the patient that the treatment can be done at home, but there is a risk that they will use the medication incorrectly, causing it to work less well. It may also happen that they continue to suffer from side effects even though this is not necessary.
It was not clear
“One of the patients turned out to take his pills with some yogurt to make them easier to swallow,” nursing consultant Bettina gives as an example. ‘We had told you that you should take them on an empty stomach and that is also stated in the package leaflet, but it was not clear to the patient what this meant. There was also a patient who developed pain in the esophagus. This was because the pills were taken lying down. We never thought that someone would do that. Another thing we found out is that the ‘risky substance’ sticker that the pharmacy is required to put on the box scares some patients. They did not dare to take the pills and thought they were some kind of chemo tablets.’
From high to low educated
The Applied Health Research department asked patients what they encounter and what they would like to see improved. They indicated, among other things, that the information was not always clear. “For example, sometimes patients interpret texts differently than intended or do not understand them,” says Bettina. ‘Lung cancer can affect anyone, from highly to poorly educated and also low-literate people, we must take that into account.’
Kind of pyramid
The entire information provision was scrutinized. Texts have been rewritten in consultation with patients and it has been agreed who provides what information and when. “We’ve turned it into a kind of pyramid,” says Bettina. ‘The first layer is the most important information that everyone needs to know and understand. We use pictograms to show when and how to take and store the medicines, what you can and cannot do, what the most common side effects are and which numbers you can call if you have any questions. The second layer contains more detailed information for those interested. This concerns, for example, how the medicine works and where you can go for contact with fellow sufferers. The third layer is the leaflet that the pharmacy provides.’
Will it work?
Before a patient starts treatment, Bettina or one of her colleagues goes through the information from layers 1 and 2 with the patient and checks whether the patient understands everything and whether he or she will be able to swallow the pills and take them on time. ‘After two weeks we call to ask how things are going, and the pharmacy does that again. When the patient comes for a scan after four weeks, we ask again how the medication is going. This way we always keep our finger on the pulse and we don’t only discover after weeks that someone is not taking the medication properly or is experiencing side effects,” says Bettina.
Openkrassen
Lung cancer patients often have a lot on their minds, which can cause them to no longer remember whether they have taken their pill or not. They also wanted a solution for that. Bettina: ‘The pharmacists have developed stickers that they can stick on the medicine box. If the patient has taken a pill, they can scratch open the box for that day. These stickers can also be used for other medicines. Everything we are now developing to help patients comply with therapy can be applied more broadly. We are creating a format that can also be used for other treatments and other hospitals.’
An app
She says that another survey was recently conducted among patients to ask what more information they would like. ‘We wanted to know whether they needed an information evening, but because many patients live further away, there is not much interest in this. But for an app that allows them to keep track of side effects. Side effects sometimes develop gradually, so that patients do not always notice them, or they accept the complaints and think: that is just part of it. But sometimes we can reduce the complaints by, for example, adjusting the dosage. We would like to explore this together with the patient.’
2023-11-18 08:07:55
#medication #properly
