Patients’ lived experiences with antineoplastic medicines prescribed for the management of malignant solid tumours : a systematic review

Abstract

Background and Objective: Cancer is a growing international health burden. It is a considered as a leading cause of morbidity and mortality with incidence expected to rise from 14 million in 2012 to 22.2 million by 2030 worldwide. In the last century, the introduction of antineoplastic medicines was revolutionary as these resulted in increased survival and improved quality of life. 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. Design: A systematic review protocol was 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. Screening was initially conducted on titles, followed by abstracts and then full papers to identify potentially relevant research. Quality assessment and data extraction of all selected papers were conducted independently by two reviewers. A data collection tool was developed. Quantitative and qualitative research findings were analysed using narrative and meta-synthesis approach respectively. Results: The search retrieved 31,004 articles with only 10 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 medicines. These are medication related burden, medication related beliefs and medication taking practice. The review showed that patients were highly adherent to treatment. They 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 Conclusion: The findings show that patients undergo a continuous process of reinterpretations of their experience with medicines throughout their treatment journey. The patients’ lived experience with medicines require more in-depth studies to enable tailoring of services and policies in the healthcare system and support patients in their treatment journey.