Patient engagement in accelerating care level activation of precision medicine with patient educational materials in Nigeria: A pilot study.

Abstract

e13583 Background: Globally, precision medicine (PM) is revolutionizing oncology treatment. PM delivers highly accurate diagnoses and targeted therapies, provides greater effectiveness for certain cancer biomarkers, and uses genomic profiles to treat cancer in many high-income countries. Due to a lack of infrastructure, limited technologies, poor health systems, workforce shortage, funding, and low awareness in many low-income countries, PM is still emerging in Nigeria. While some targeted therapies are available to cancer patients in Nigeria, patient education on precision medicine is largely unknown. The study aims to explore cancer patients’ perspectives on the PM materials and their access to targeted therapies. Methods: Participants were ( N = 147 ) cancer patients aged (18-68 years) who were recruited from two cancer support groups. Using patient engagement, From the Testing to Targeted Treatments co-created patient educational materials (PEMs) on “biomarker testing for cancer treatment,” “targeted therapy for cancer,” and “questions to ask your healthcare provider.” The PEMs were adapted and reviewed by a breast cancer patient and two patient advocates at Project PINK BLUE. Prior to data collection, the PEMs were sent to all the patients. Using a concurrent embedded mixed method design, 76 of the participants completed an online survey on the usefulness of PEMS, and 71 participated in three focus group discussions on access to targeted therapies. The qualitative data were then subjected to inductive/deductive thematic analysis, and the quantitative were analyzed using descriptive statistics. Results: The findings showed that 98.7% of participants were female, 53.9% earned N65,000 ($38.24) monthly, 86.8% lived in urban areas, and 67.1% had higher education degrees. The majority of the participants, 71.1% reported an increase in awareness of precision medicine, 80.3% found the materials helpful for making informed medical decisions with their oncology professionals, and 90% rated the materials highly for clarity. The following themes were identified: “financial barriers to targeted therapies,” “poor awareness of targeted therapies,” and “lack of access to PEMs.” The qualitative findings showed that some of the cancer patients were taking targeted therapies but were unaware of treatment. A participant said, "Some of us are even undergoing it without knowing that it’s targeted therapy. We feel the cost is too high, and even when we have the money, sometimes it’s still not affordable." Conclusions: Our finding underscores the urgent need for the acceleration of PM through patient engagement and education at care levels. The PEMs are useful to the patients. However, there is a need to engage oncologists and other healthcare providers to educate patients on treatments to engender shared decision-making in Nigeria.

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