Abstract
As a result of bio-medical research and pharmaceutical advances many chemotherapy drugs and supportive medications are now available orally to be used throughout the illness trajectory and they are the current ‘gold standard’ for treating the cancer called myeloma. The aim of this study is to understand how information about oral chemotherapy is delivered to patients who are starting oral chemotherapy for myeloma. The study draws on a case study approach using mixed methods. Audio recordings of 10 clinical consultations between doctors, clinical nurse specialists and patients at three NHS trusts were carried out in 2010-2011 as well as a self-completion questionnaire (n=70) and interviews with clinical nurse specialists and patients (n=6). The results identify how staff adopt the ‘information delivery mode’ during consultations about oral chemotherapy. Information was framed in relation to adopting “a new normal”, use of scare tactics to impart a sense of urgency, gravity and risk in relation to the medication. Surprisingly, adherence with the medication regime did not feature as a key issue in consultations. Staff used the ‘information delivery’ format in contrast to the ‘interview format’. The advantage of the information delivery format is that a lot of information can be given to patients over a short period of time. The interview format is one recommended by Silverman (1997) where nurses ask patients questions to which patients provide answers and this gives patients an opportunity to express their own concerns and fears about their medications and to receive information targeted to their needs. A move to adopting the interview format by nurses will enable information to be more closely aligned with the patients own needs and concerns.