Oral therapy, even for chronic pathologies, is revolutionizing the world of medicine. While simplifying the administration of medication re-defines the doctor-patient relationship, there are some psychological repercussions that need to be carefully considered.
The revolution of oral therapy
The Italian Medicines Agency (AIFA) says, “the introduction of innovative medicine on the market has put the world of health care in a condition of dealing with a momentous revolution. We have recently witnessed advancements and are expecting many more in several different therapeutic fields, with important and innovative drugs to cure pathologies like cancer or cardiovascular diseases.”
It is like an earthquake that is positively affecting all the links in the doctor-patient chain. Drugs with greater specificity and more effectiveness are only the first of many advantages. Silvia Tonolo, president of Anmar (National Association of Rheumatic patients), states, “The arrival of medication that can be taken orally facilitates the life of the patient. The patient does not miss as much work, is saved travel time and does not need to ask as much help from relatives and/or caregivers. Oral therapy is also more warmly welcomed than a syringe that often produces fear and is often a reason patients do not adhere to injection therapy. “One example is a new drug in tablets for the treatment of rheumatoid arthritis that will substitute daily injections, undoubtedly improving adherence to treatment as a result, and the new drugs for chronic hepatitis B and C. In Italy, Ibrutinib, the first of a new class of biological drugs that can be taken orally as an alternative to chemotherapy, has been launched.
Oral therapy, however, does bring about some difficulties. For example, drug interactions can be caused by a large number of drugs that are administered at the same time when following more complex dosing schedules. Self-administration of medication also leads to a higher rate of error, especially in elderly patients. Thus, even though patients can be well-informed and instructed about new types of oral therapy, self-administration can lead to some problems with adherence to treatment.
A significant psychological side effect
Oral therapy can substitute more invasive and time-consuming treatments such as intramuscular injections and infusions. There is one side effect, however, that especially affects patients who have been chronically ill for some time and that can negatively affect their adherence to treatment. These types of patients are often used to a daily relationship with health assistants and caregivers and this routine has become a legitimate crutch for them to lean on in properly carrying out their treatment. The introduction of oral therapy, however, revolutionizes and greatly simplifies these patients’ routine practically overnight, leaving them with a much smaller number of people to connect with and on a much less frequent basis. The patient risks suddenly feeling empty or abandoned with obvious and natural consequences that worsen other aspects too, such as adherence to treatment.
Through its Patient Support Programs, for some time Domedica has taken into consideration the movement towards oral therapy in order to fill the void perceived by some patients. Online and offline services including:
- Appointment scheduling, appointment reminders and medication expiration reminders
- Practical and emotional support
- Home delivery of therapy and devices
- Self-administration training
- Telephone appointments agreed upon by the physician/caregiver and patient
help the patient in the difficult transition from one therapy to the next, all while making the patient feel he is at the center of a support network that regards all aspect of his life.
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