Ann Hewison, Eve Roman, Alexandra Smith, Dorothy McCaughan, Rebecca Sheridan, Russell Patmore, Karl Atkin, Debra Howell
{"title":"慢性粒细胞白血病:关于患者和医生治疗管理经验的定性研究","authors":"Ann Hewison, Eve Roman, Alexandra Smith, Dorothy McCaughan, Rebecca Sheridan, Russell Patmore, Karl Atkin, Debra Howell","doi":"10.1155/2023/6646271","DOIUrl":null,"url":null,"abstract":"<div>\n <p><i>Background</i>. Following the dramatic impact of tyrosine kinase inhibitor (TKI) drugs on chronic myeloid leukaemia (CML) survival, research interest has grown into the long-term impact of treatment, identifying difficulties with medication adherence and ongoing side effects. Qualitative studies suggest the disease has a significant physical and psychological impact on patients, and medication management may be complex. However, only one study worldwide has examined healthcare practitioner (HCP) experiences of managing CML treatment and very little UK qualitative research exists exploring the patient experience. <i>Purpose</i>. Our qualitative study aimed to investigate both patient and HCP experiences of managing CML treatment in the UK. <i>Methods</i>. Patients and HCPs were purposively sampled from within the Haematological Malignancy Research Network (HMRN), a UK population-based patient cohort. Qualitative interviews were carried out with seventeen patients and thirteen HCPs, and data were analysed using thematic analysis. <i>Results</i>. Four themes were developed from interview analysis: “Importance of optimal clinical management,” “Multiple adherence strategies,” “Inconsistent management of adherence,” and “Controlling side effects is complex.” HCPs tended to focus on sometimes complex, clinical decision-making. Patients described various strategies to support adherence and manage side effects, some of which HCPs seemed to be less aware of. Several patients did not discuss non-adherence or side effects with their HCP, who tended to avoid direct enquiry regarding adherence and could be uncertain about adherence advice, whilst relying on medical strategies to manage side effects. <i>Conclusions</i>. Despite HCPs focusing on the medical management of CML treatment, patients may opt to use self-management techniques to control adherence and side effects and can be reluctant to discuss related difficulties. Increased clinic time and clear adherence advice guidance may support such discussion, in addition to adjusting the context of follow-up care through the introduction of shared care with GP services.</p>\n </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2023 1","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6646271","citationCount":"0","resultStr":"{\"title\":\"Chronic Myeloid Leukaemia: A Qualitative Study of Patient and Practitioner Experiences of Managing Treatment\",\"authors\":\"Ann Hewison, Eve Roman, Alexandra Smith, Dorothy McCaughan, Rebecca Sheridan, Russell Patmore, Karl Atkin, Debra Howell\",\"doi\":\"10.1155/2023/6646271\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><i>Background</i>. Following the dramatic impact of tyrosine kinase inhibitor (TKI) drugs on chronic myeloid leukaemia (CML) survival, research interest has grown into the long-term impact of treatment, identifying difficulties with medication adherence and ongoing side effects. Qualitative studies suggest the disease has a significant physical and psychological impact on patients, and medication management may be complex. However, only one study worldwide has examined healthcare practitioner (HCP) experiences of managing CML treatment and very little UK qualitative research exists exploring the patient experience. <i>Purpose</i>. Our qualitative study aimed to investigate both patient and HCP experiences of managing CML treatment in the UK. <i>Methods</i>. Patients and HCPs were purposively sampled from within the Haematological Malignancy Research Network (HMRN), a UK population-based patient cohort. Qualitative interviews were carried out with seventeen patients and thirteen HCPs, and data were analysed using thematic analysis. <i>Results</i>. Four themes were developed from interview analysis: “Importance of optimal clinical management,” “Multiple adherence strategies,” “Inconsistent management of adherence,” and “Controlling side effects is complex.” HCPs tended to focus on sometimes complex, clinical decision-making. Patients described various strategies to support adherence and manage side effects, some of which HCPs seemed to be less aware of. Several patients did not discuss non-adherence or side effects with their HCP, who tended to avoid direct enquiry regarding adherence and could be uncertain about adherence advice, whilst relying on medical strategies to manage side effects. <i>Conclusions</i>. Despite HCPs focusing on the medical management of CML treatment, patients may opt to use self-management techniques to control adherence and side effects and can be reluctant to discuss related difficulties. Increased clinic time and clear adherence advice guidance may support such discussion, in addition to adjusting the context of follow-up care through the introduction of shared care with GP services.</p>\\n </div>\",\"PeriodicalId\":11953,\"journal\":{\"name\":\"European Journal of Cancer Care\",\"volume\":\"2023 1\",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2023-11-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6646271\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Cancer Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/2023/6646271\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Cancer Care","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/2023/6646271","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Chronic Myeloid Leukaemia: A Qualitative Study of Patient and Practitioner Experiences of Managing Treatment
Background. Following the dramatic impact of tyrosine kinase inhibitor (TKI) drugs on chronic myeloid leukaemia (CML) survival, research interest has grown into the long-term impact of treatment, identifying difficulties with medication adherence and ongoing side effects. Qualitative studies suggest the disease has a significant physical and psychological impact on patients, and medication management may be complex. However, only one study worldwide has examined healthcare practitioner (HCP) experiences of managing CML treatment and very little UK qualitative research exists exploring the patient experience. Purpose. Our qualitative study aimed to investigate both patient and HCP experiences of managing CML treatment in the UK. Methods. Patients and HCPs were purposively sampled from within the Haematological Malignancy Research Network (HMRN), a UK population-based patient cohort. Qualitative interviews were carried out with seventeen patients and thirteen HCPs, and data were analysed using thematic analysis. Results. Four themes were developed from interview analysis: “Importance of optimal clinical management,” “Multiple adherence strategies,” “Inconsistent management of adherence,” and “Controlling side effects is complex.” HCPs tended to focus on sometimes complex, clinical decision-making. Patients described various strategies to support adherence and manage side effects, some of which HCPs seemed to be less aware of. Several patients did not discuss non-adherence or side effects with their HCP, who tended to avoid direct enquiry regarding adherence and could be uncertain about adherence advice, whilst relying on medical strategies to manage side effects. Conclusions. Despite HCPs focusing on the medical management of CML treatment, patients may opt to use self-management techniques to control adherence and side effects and can be reluctant to discuss related difficulties. Increased clinic time and clear adherence advice guidance may support such discussion, in addition to adjusting the context of follow-up care through the introduction of shared care with GP services.
期刊介绍:
The European Journal of Cancer Care aims to encourage comprehensive, multiprofessional cancer care across Europe and internationally. It publishes original research reports, literature reviews, guest editorials, letters to the Editor and special features on current issues affecting the care of cancer patients. The Editor welcomes contributions which result from team working or collaboration between different health and social care providers, service users, patient groups and the voluntary sector in the areas of:
- Primary, secondary and tertiary care for cancer patients
- Multidisciplinary and service-user involvement in cancer care
- Rehabilitation, supportive, palliative and end of life care for cancer patients
- Policy, service development and healthcare evaluation in cancer care
- Psychosocial interventions for patients and family members
- International perspectives on cancer care