Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

99 Problems and the Medicines Are One: Experiences of People Managing a Pre-Existing Chronic Condition through Cancer Diagnosis and Treatment (#230)

Lauren Cortis 1 , Bogda Koczwara 2 , Ross McKinnon 1 , Paul Ward 1
  1. College of Medicine and Public Health, Flinders University, Adelaide, SOUTH AUSTRALIA, Australia
  2. Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Adelaide, SA, Australia

To explore the experiences of people using medicines to manage pre-existing chronic conditions throughout cancer diagnosis; to describe the types of disruptions in care that are experienced and identify opportunities for medication management services (MMS) to enhance the care experience.

Semi-structured in-depth interviews were conducted with a convenience sample of adults within 18 months of cancer diagnosis using at least one medication to manage a pre-existing chronic condition. Nine interviews were conducted, fully transcribed and thematically analysed. Eight females and one male were interviewed, representing various demographic characteristics. Thematic saturation of the primary aim was achieved.

Medication taking processes were normalised behaviours amongst participants, who accepted medication as an ongoing part of their lives. Participants did not recognise or express feelings to indicate they had a need for formal support for medication management, even in circumstances where healthcare providers thought otherwise or where there was evidence of objective need.

Disruptions of care were described as explicit events by participants, or expressed as feelings of frustration, confusion, or uncertainty about something that occurred. Disruptions typically occurred early in the disease trajectory; during diagnosis, surgery, and chemotherapy treatment planning. Once connected with the cancer care team participants described feeling well supported. Participants responded to disruptions involving medication by taking control or being compliant. Participants demonstrated intraindividual variation in their responses depending on contextual factors, demonstrating that medication management is a complex and dynamic phenomenon.

People managing cancer and chronic conditions experience disruptions in care which could be reduced or managed through MMS, specifically in circumstances where patients fall outside the safety net provided by the cancer care team. The challenge to overcome is not the MMS product, but how to engage consumers to participate in a service if they do not feel they need support or recognise medication-related issues are present.