| Popis: |
Elise Verot,1 Claire Falandry,2 Véronique Régnier Denois,1 Corinne Feutrier,3 Boris Chapoton,1 Jean Okala,4 Sidonie Pupier,4 Vanessa Rousset,4 Françoise Bridet,3 Christine Ravot,2 Catherine Rioufol,5 Véronique Trillet-Lenoir,6 Magali Hureau,7 Franck Chauvin,1 Aurélie Bourmaud8 1University of Lyon, University of Saint-Etienne, Centre Hygée, HESPER EA 7425, Rue de la Marandière, Saint-Priest-en- Jarez, 42270, France; 2Oncogeriatrics Department, Lyon Sud Teaching Hospital & Claude Bernard University, Lyon, France; 3Transversal Unit of Patient Education of Department of Rhône, Hospices Civils de Lyon, Lyon 69004, France; 4Public Health Department, Centre Hygée, Institut de Cancérologie Lucien Neuwirth, HESPER EA 7425, Saint-Priest-en-Jarez 42270, France; 5Pharmacy Department, Lyon Sud Teaching Hospital & Claude Bernard University, Lyon, France; 6Medical Oncology Department, Lyon Sud Teaching Hospital & Claude Bernard University, Lyon, France; 7Department of Clinical Research and Innovation, Léon Bérard Cancer Centre, Lyon, France; 8Clinical Epidemiology Unit, Robert Debré Hospital, AP-HP, INSERM CIC-EC 1426; INSERM 1123 ECEVE, University of Paris, Paris, FranceCorrespondence: Elise VerotUniversity of Lyon, University of Saint-Etienne, Centre Hygée, HESPER EA 7425, Rue de la Marandière, Saint-Etienne 42270, FranceTel +33-682309796Email elise.verot@univ-st-etienne.frIntroduction: A patient education program has been developed in the field of cancer for supporting cancer patients undergoing oral anticancer therapies. Its implementation was tested in 3 different settings. The objectives of this study were to 1) identify barriers and facilitators for implementing the patient education program, 2) identify practices encouraging or hindering implementation and 3) produce recommendations for its dissemination.Methods: Twenty semi-structured interviews were conducted with caregivers from all three establishments.Results: The main factors associated with successful implementation were as follows: prescribers’ representations on patient education, considered of low value; on oral anticancer therapies, considered too dangerous to be handled by the patient him/herself, the indefinite legitimacy of certain professions in charge of patient education programs; patients’ engagement in their care pathway and provision of caregivers.Conclusion: Recommendations include developing patient education culture within the environment of the medical doctors’ curriculum, to consider contextual, pre-existing cooperative units for implementing patient education, to systematically send patients to patient education programs without practicing triage. Successful implementation of patient education critically depends on the prescribing physicians’ perceived value of patient education. Patient education should become mandatory, integrated as part of the cancer care pathway. Physicians lack the necessary time and/or means to assess patients’ capacity for engagement, without adequate strategies for their support. Therefore, physicians should systematically refer all patients to patient education, where nurses can tailor their coaching of cancer patients.Trial Registration: The study protocol was approved by the IRB SUD EST I (N° EudraCT: 2016-A00113-48). All participants were given written and verbal information about the study and gave informed consent to participate.Keywords: oral anticancer therapy, implementation science, patient education, theoretical domains framework |
