Congress Abstracts 2005

243

PREFERENCES FOR ORAL VERSUS PARENTERAL ANTITUMOR THERAPY: A SURVEY OF PATIENTS WITH METASTATIC BREAST CANCER. Neil Love, MD, Research to Practice, Miami, FL; Karen J. Stanley, RN, MSN, AOCN^®, FAAN, Self-Employed, Greenwich, CT; Jennifer Love, BS, and Richard Kaderman, PhD, Research to Practice, Miami, FL; Douglas Paley, BA, Self-Employed, Miami, FL; and Michelle Paley, MD, Research to Practice, Miami, FL.

Oral and parenteral therapies used to treat patients with metastatic breast cancer often have similar risk-to-benefit ratios, particularly in the context of palliative treatment. Oncology nurses often assume that patients prefer oral therapy because of perceived inconvenience and discomfort associated with parenteral therapy. However, the life circumstances and biopsychosocial milieus of patients with metastatic breast cancer are complex, and oncology nurses should explore treatment options with patients so needs and preferences can be individualized and honored.

The objective of this evaluation was to determine patient preferences with regard to route of administration. This information enables oncology nurses to assist in individualizing treatment, serve as effective patient advocates and educate patients regarding treatment options.

Patients with metastatic breast cancer—recruited nationally via oncology offices and support groups—voluntarily participated in a 250-item anonymous telephone interview. Two new treatments of equal efficacy and tolerability were presented, and patients were asked their preferences for the route of administration. The survey attempted to correlate these preferences with lifestyle factors and attitudes.

154 patients with metastatic breast cancer (153 females, 1 male, mean age 56.7 years) were interviewed. Overall, 65% preferred oral chemotherapy, 28% intravenous chemotherapy, and 7% were neutral. Similarly, 56% preferred oral endocrine therapy, 35% intramuscular endocrine therapy, and 9% were neutral. Patients preferring parenteral therapy cited concerns about compliance (40%), dislike of oral medications (30%), the belief that parenteral therapy is more effective (61%), the emotional support received during parenteral therapy (61%), and convenience (72%). Patients who spent <15 minutes traveling to the oncologist’s office were more likely to prefer parenteral therapy (47%) than those traveling >15 minutes (22%). No correlation was observed between patient age and treatment administration preference.

A substantial percentage of patients with metastatic breast cancer prefer parenteral therapy. The biopsychosocial determinants of these preferences are complex and not age-correlated. In situations in which two comparable treatment options are available, the oncology nurse must not presume patient preference but rather educate patients about available options, support informed decision-making and choice regarding treatment preferences.