How to prepare patients to play an active part in their treatment
Faculté des sciences pharmaceutiques de l’université Paris Descartes, Paris, France
The development of oral forms in the treatment of cancer patients is causing a major upheaval in the organisation of management and in the health education of patients.
Conventionally, patients are given their anti-tumoral treatment in a session at a day hospital. Their hospitalisation offers a special period of time during which the care givers can « educate » patients in the management of their treatment and in the detection of any side effects likely to occur.
For patients treated orally, there is a shift of responsibility to the patient who becomes the person in charge of the proper organisation of his or her treatment. Just as with injectable treatments, the patient will have to be taught to detect, assess and manage a certain number of iatrogenic situations such as the cutaneous disorders caused by EGF-R inhibitors or blood pressure disorders induced by anti-angiogenics. Patients will also have to be made aware of the problems of compliance so as to avoid the double pitfall of over-compliance and under-compliance and of the timing for taking their medication.
The various educational messages aimed at giving support to patients in the shift leading them or their families to the status of care giver are difficult to imagine within the context of a medical consultation, hence the value of therapeutic education programmes.