Conditions for the Implementation of a Patient Education Program Dedicated to Cancer Patients Treated by Oral Anticancer Therapy

Figures & data

Table 1 Participants Characteristics

N = 20	N (%)
Profession
Prescriber (MD)	4 (20%)
Pharmacist	5 (25%)
Nurse manager	2 (10%)
Nurse educator	2 (10%)
Coordination nurse	5 (25%)
PE project manager	2 (10%)
Centres
1	12 (60%)
2	4 (20%)
3	4 (20%)
Age
[20–45] years old	11 (55%)
[46–65] years old	9 (45%)
Female	16 (80%)
Male	4 (20%)

Table 2 Barriers and Facilitators Encountered During PE Program Implementation

	Barriers	Facilitators
According to the specific occupations	Prescribers of oral anticancer therapies prefer a patient surveillance approach rather than an educational approach Coordinating nurse’s representation on their everyday practice Prescribers have difficulty considering PE as a central link in the support of patients treated with oral anticancer therapies Prescribers do not believe in PE, specifically dedicated to oral anticancer therapies
Related to the global system mode of operation	The lack of transport support to integrate a PE program The provision of caregivers for the PE program, in the absence of dedicated staff	Legitimacy of pharmacists to take over PE to strengthen the city-hospital link as part of oral anticancer therapies prescriptions The legitimacy of the prescriber, as a Medical Doctor, to coordinate the PE program, from the perspective of all the caregivers
Declared as related to patients’ characteristics	Patients’ engagement is not constant

Table 3 Practices to Enhance or to Hinder Implementing a PE Program Dedicated to Oral Anticancer Therapies

Practices to Hinder	Practices to Enhance
#1 Construct the program by bringing together PE experts and novices	#1 Construct the PE program as a team cohesion tool, abolishing hierarchies and allowing the recognition of the skills of all
#2 Construct the program by excluding nurse educators	#2 Be transparent about the fact that the PE program is a means to collectively move from a paternalistic to a patient-centered approach
#3 Compare and replicate the project of a previous program that failed using the same process
#4 Bring together two specialties that, historically, have failed to work together

Table 4 Recommendations Tracks for the Dissemination of a PE Program Dedicated to Cancer Patients Undergoing Oral Anticancer Therapies

1.The PE has a statement of mission and a statement of philosophy which concisely identify the purpose and reflect the value of the program^Citation19 In order for a PE program in oral anticancer therapies to be implemented and to be functional, statements setting out the philosophy and organization of patient education must be made at the institutional level. These declarations must be shared and their values instilled in all professionals of the establishment.

2.The PE staff are empowered and accountable for administering patient education programs and activities: written rules attest that it is the staff of the PE program who decide, who is responsible for its development, implementation, coordination and evaluation.^Citation19 Co-construction of a PE program must include the entire team of stakeholders. In addition, institutional support would make it possible to legitimately position stakeholders in the eyes of all professionals with regard to the implementation of a new intervention, a new project.

3.The stakeholders should already be used to working together for existing care, with common processes and common cultures, before implementing a shared patient education program

4.The patient education coordinator should belong to the care team, and be a key opinion leader inside the team

5.Patient empowerment culture should be widespread to include all healthcare workers’ curriculum

6.Medical Doctors prescribers should be sensitized and trained during their courses in patient education. They are the cornerstone of the patient pathway and adherence

7.Patient education should be mandatory care, integrated care as part of the cancer care pathway, mandated and facilitated by the National Health System

8.Patients should systematically be directed to the patient education program, regardless of the impression the care givers may have of the patient’s willingness to participate or regardless of the care givers detrimental beliefs towards patient education

9. Communication based on a patient education program should be handled with care and a professional approach: communications to other caregivers, managers and patients have different ways and purposes

Guidelines for Establishing Comprehensive Cancer Patient Education Services.

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