Experience of Medication Adherence in Patients with Recurrent or Metastatic Breast Cancer Receiving Oral Chemotherapy

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  • 経口抗がん薬治療を受ける 再発・転移性乳がん患者の服薬に関する経験
  • ケイコウ コウガンクスリ チリョウ オ ウケル サイハツ ・ テンイセイ ニュウガン カンジャ ノ フクヤク ニ カンスル ケイケン

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Abstract

<p>Abstract</p><p>Objectives：To identify the experiences of medication adherence of patients with recurrent or metastatic breast cancer. Methods：Qualitative descriptive study. Participants：Four female outpatients with recurrent or metastatic breast cancer receiving oral chemotherapy at a university hospital in Tokyo. Data collection：We conducted longitudinal semi-structured interviews （3-4 times） in a private room at an outpatient clinic. Questions included, “How do you manage your current oral chemotherapy?” and, “What is the significance of oral chemotherapy for you?” Results：The following themes emerged from the reported experiences of the four participants：“An imbalance between the threat of death and daily living”（ participant A）; “Inner conflict between the value of maintaining a normal life and when to withdraw from treatment”（ participant B）; “Inner conflict over significance of uncomfortable medication”（ participant C）; and “Reminding oneself to continue medication for survival” （participant D）. Patients gave the oral anticancer drugs meaning as a “savior” or “means for survival” and adhered to medication when the threat of death or anxiety increased. However, when the threat of death was relieved, when they were concerned about physical harm, or when increased feelings of avoiding taking medicine occurred, they repeatedly skipped medication either unintentionally or intentionally. Conclusions：Patients with recurrent or metastatic breast cancer experienced ambivalent feelings about oral chemotherapy between positive emotions：recognition of gratitude and expectation of treatment; and negative emotions：recognition of physical harm and uncertain treatment effects. In addition, patients created a meaning for the treatment through repeated self-reflection of their life and values. These values regarding oral chemotherapy affected their medication behavior, such as skipping medication unintentionally, intentionally or adhering to medication. In conclusion, other provisions in addition to medication adherence support are required. Support based on understanding the meanings of patient behavior and/or suppressed emotions is vital.</p>

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