13.03.2019: CANCER PATIENTS AS CO-PRESCRIBERS
Cancer treatment is very challenging for patients and their families because there are multiple effective therapies with a complex interplay between their benefit and risks.
Treatment recommendations are based on complicated clinical and laboratory information which are integrated into a treatment plan.
The growing focus on patient – centered oncology care is increasing the demand on physician’s time to engage patients and their families in treatment decision making.
There is strong evidence that more engaged patients are better informed, more satisfied with better psychological and often physical outcome. Time spent in the doctor’s office is frequently suboptimal for cancer patients to absorb all relative information. Especially, for newly diagnosed patients, there is a steep learning curve to understand and make complex decisions about treatment.
Therefore it is particularly important for patients and care givers to participate and co-operate with the oncology team on permanent basis. This strengthen the psychology of the patients and increases the self-confidence.
Participatory medicine is a model of medical care in which the active role of the patient is emphasized according to Wikipedia.
This active role of patients as co-prescribers is not limited only to medicine or radiotherapy. It includes all aspects of quality of life as well.
The participation of patients in the discussion and decision making process in issues such as diet, physical activity, social habits, sexual behavior is of paramount importance.
Barriers in the participatory medicine are the time dedicated for the discussion of clinician and patient which is getting more and more limited. Also, the frequent face to face contact which is diminished due to work overload from the physicians side but also the difficulties of moving to the hospital from the patients side.
Different ways of enabling the patients in participatory medicine are necessary. Individualized, tailored – made contact with the patients discussing problems of eating, diarrhea or constipation, drug toxicities, exercise, well – being etc are mandatory.
Treatment affect the quality of life and the daily activity of each patient. It is so important for persons to continue their work as well as the family and social life. Therefore for certain cancers, treatment adjustment based on patients’ needs following discussion, may enhance psychology, self-confidence maintain the daily life style, without jeopardizing the cancer treatment outcome.
In women cancer patients the decision for total vs partial mastectomy, chemotherapy induced hair loss or not, hormonotherapy induced amenorrhea or not, are of critical importance.
Women with breast or ovarian cancer are willing to participate in discussions with the oncology team to co – decide about the details of treatment. This participation eliminate the anxiety about side effects and quality of life. Patients adhere to the protocol and feel part of the solution.