Systematic review contributing to an understanding of the patients' lived experience with medicines with reference to antineoplastic medicines

Abstract

Background: The patient's lived experience with medicines (PLEM) provides a detailed understanding and interpretation of the patient's beliefs, practices and burden in relation to the use of medicines. The use of antineoplastic medicines as part of cancer treatment was revolutionary during the last century as these resulted in increased survival, improved quality of life but poses risks of toxicity. The aim of this systematic review was to critically appraise, synthesise and present the available evidence of patients’ lived experiences with antineoplastic medicine for the management of malignant solid tumours. Methods: A systematic review protocol was compiled and registered with PROSPERO. The search was applied to six databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Cochrane Database of systematic reviews, Embase, International pharmaceutical abstracts and PsycArticles. Quality assessment and data extraction of all selected papers were conducted independently by two reviewers. Research findings were analysed using narrative and meta-synthesis for quantitative and qualitative data respectively. Results: The search strategy identified 31,004 articles with only ten studies meeting the inclusion criteria. Two studies were quantitative studies and 8 studies followed qualitative methodology. These studies were published between 2005 and 2016 in Europe (n=6), America (n=3) and Asia (n=1). Three interrelated themes contribute to patients’ lived experience with medicine, which are medication related burden, medication related beliefs and medication taking practice. PLEM is based on interaction between the characteristics of the patient and the medicines with influences from various sources including family members, friends and healthcare professionals. Patients commonly suffered from adverse effects that were delayed to be reported to healthcare professionals, possibly due to fear of modification or discontinuation of treatment. This adversely affected treatment outcomes. Conclusions: Patients tend to undergo a continuous process of reinterpretations of their experience with medicines throughout their treatment journey. Further longitudinal in-depth studies are required to provide deeper insight on PLEM and will enable tailoring of services and policies in the healthcare system which support patients in their treatment journey.