Patients With Cancer: Experiences of Medication Management

Monday, 7 July 2008: 3:35 PM
Mikel W. Hand, EdD, MSN, RN, OCN, CNA, BC , Nursing/College of Natural Science, California State University San Bernardino, San Bernardino, CA
Marilyn Smith-Stoner , Nursing/College of Natural Science, California State University San Bernardino, San Bernardino, CA

Learning Objective 1: Describe barriers identified by patients related to medication management in late stage cancer.

Learning Objective 2: Identify potential strategies to improve the process of medication management in late stage cancer.

Background: The ability of patients to self manage a complex medication regimen is a common concern for clinicians; particularly for patients who are elderly and coping with symptoms of late stage cancer. Inquiry is needed in order to understand the experience of medication management in patients who have cancer and to explore how elderly patients with cancer respond to ongoing changes in their medication regimen and barriers they face in this process.

Methodology/Participants: Descriptive phenomenology was used for this pilot study. 11 participants with a diagnosis of late stage cancer were selected in a small retirement community in the Western United States. Interviews took place in an outpatient cancer center. Interviews were tape recorded, transcribed verbatim, coded individually by each of the 2 researchers, and then discussed to reach consensus in regard to the findings.

Findings: 4 primary themes emerged: Surrender, lack of system for comprehensively managing medications, problems with medication labeling, and limited use of available resources for medication management. Participants described surrendering decisions related to medication management to their provider. The systems for medication management described by participants included attempting to memorize when medications need to be taken, using a bowl to determine when medications need to be taken, and depending on the physician tracking as to what they should be taking. Problems with labeling were consistently reported including small print and the purpose of medication not being listed. Participants also reported not consulting available resources such as a pharmacist.

Implications/Recommendations: Implications from this pilot study include the need to educate patients regarding systems by which to manage medications and the need to increase the size of labels, as well as including the purpose on the label. Additional research is needed involving patients experiencing late stage cancer in order to address their complex needs related to medication management.