CN96 - Patient education to support self-management and self-efficacy during immunotherapy: An integrative review

Background

Immune checkpoint inhibitors (ICI) have improved survival of patients with cancer, but severe and potentially lethal immune-related adverse events (irAEs) may be difficult to identify and manage. Patient and caregiver education may ensure timely identification and prevention of irAEs. This study aims to elucidate existing knowledge of education of patients with cancer receiving ICI and their family caregivers, focusing on patients’ and caregivers’ self-management and self-efficacy.

Methods

An integrative review was conducted. EMBASE, MEDLINE, CINAHL, PsycINFO and Scopus were searched for primary studies conducted in oncological settings. Data were analyzed using thematic analysis. We present preliminary data that will be updated for the presentation.

Results

From 4,182 screened references, eight studies (n=7 quantitative, n=1 qualitative) were included from six countries: Germany, Canada, USA, Italy, Spain and Australia. Seven studies included patients and one study included both patients and caregivers. Two studies evaluated patients’ health literacy and up to 41% of patients had limited health literacy. Three themes emerged: (a) Feasibility of patient education, (b) Self-efficacy and irAEs and (c) Self-management of irAEs. Information leaflets aid irAE recognition and management. However, innovative ways, such as digital education and apps, seems more feasible compared to leaflets for educating patients and caregivers about ICI and irAEs. Patient education can lead to improved comprehension of irAEs and have a positive impact on patient self-efficacy, early detection and self-management of irAEs. Next to patient education, the method of detecting irAEs was mainly by patient self-reporting.

Conclusions

Limited evidence exists on ICI patient education and how it affects self-management and self-efficacy of irAEs. Patient education has the potential to improve both, leading to early identification and management of irAEs. However, the caregiver perspective is underrepresented in the literature and should be included in future research, focusing on innovative and tailored patient and caregiver education accounting for patients’ and caregivers' health literacy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

The Danish Cancer Society AgeCare - Academy of Geriatric Cancer Research.

Disclosure

All authors have declared no conflicts of interest.