Empowering cancer patients through ambulatory chemotherapy

It has been often reported that cancer patients experience a sense of loss of control towards their fluctuating symptoms and disease management. Studies have shown that shared decision making can empower patients, improve adherence and overall quality of life. One innovation in this context is ambulatory chemotherapy (AC), delivering chemotherapy to patients outside the hospital using a portable elastomeric infusion pump. AC is renowned for decreasing cost of care, enhancing quality of life, and empowering patients to regain control and normalcy. AC has become the standard of care for certain cancers in most developed countries. In Lebanon, AC is not widely adopted yet despite the substantial demands for healthcare services and outstanding expenses. This presentation will highlight the main findings of semi structured interviews conducted with patients, in two hospitals in Lebanon, on their perception of AC. The results of this research study will also accentuate the pharmacists‘ role in counselling patients to meet their needs, and overcoming the barriers to innovation. The first identified barrier for AC is the cultural understanding of cancer as a stigmatized disease. A remarkable contributor to identity threat is cancer visibility, there was an explicit fear of their diagnosis becoming known to others whereby carrying the pump in public would ‟expose them”. Second, the dominating paternalistic approach of care is further restricting the uptake of AC. This concept comes in tune with the lack of patient empowerment. Introducing shared decision making as a model for clinical practice is paramount to overcoming this barrier. Third, the lack of infrastructure for adopting AC and its absence from national reimbursement schemes make it less appealing to oncologists and patients. There is a huge potential for AC in Lebanon to empower patients and nurture their personal development, and pharmacists can lead a paramount role in fostering this practice.