Developing an intervention for cancer patients prescribed oral chemotherapy: a generic patient diary

Oral chemotherapy is playing a prominent role in the development of new cancer treatments. Research suggests that although oral chemotherapy is viewed as easier to manage and more cost effective than intravenous alternatives, patients do not always find it easier to cope with. The research reported in this paper comprised three phases, a review of the literature, an ethnographic study and a feasibility study. The ethnographic study focused on the experience of patients undergoing oral chemotherapy and demonstrated that patients, carers and family members found managing the treatment challenging. Many highlighted that a patient held diary would assist them with maintaining adherence, recording doses taken and identifying side effects. The authors worked closely with stakeholders, including patients, to corroborate what key elements should be included in such a diary. A generic diary was then introduced into clinical practice and its acceptability explored through a feasibility study. The results of this study showed that patients found the diary effective and useful. Trends emerged showing an association between effective symptom management and increased self-efficacy. The research also highlighted that the diary should be supported by a model of care to enhance education and reiterate information. Use of the diary, and a model of care to support it, could enable concerns highlighted about patient safety and the risks associated with oral chemotherapy to be addressed.