Mapping the patient journey: Understanding oral anticancer medication use among patients diagnosed with breast cancer

IntroductionA growing number of patients with breast cancer use oral anticancer medications (OAMs) but may face barriers in managing their therapy at home, potentially impacting their treatment outcomes. Understanding these barriers is essential to designing effective interventions. This study aimed to identify unmet medication management needs of patients with breast cancer receiving OAMs.MethodsQualitative semi-structured interviews were conducted to create patient-specific journey maps describing OAM use. Participants were recruited from a federally qualified health center's breast cancer clinic in central Indiana. Eligible patients were 18 years of age or older, diagnosed with breast cancer, and currently receiving OAMs. Participants completed a sociodemographic survey, and researchers and participants collaborated to create visual storyboards of medication use experiences, highlighting timelines, key markers, and barriers. Journey maps were consolidated, and personas were created to represent patients with similar characteristics. Participants were categorized by medication type: specialty (requiring specialty pharmacies) or traditional (available at community pharmacies).ResultsTwelve participants (11 females, 1 male; median age 65.5 years, range 37-75) were interviewed. Four were receiving specialty medications (palbociclib, ribociclib), and eight were receiving traditional medications (tamoxifen, anastrozole, exemestane). Two personas were created. The specialty medication group reported difficulties navigating the insurance system, whereas the traditional group did not. All participants experienced side effects, and sub-optimal adherence (n = 2) was reported only in the traditional group.ConclusionThis study provides insights into the patient experience with OAMs. Personas and journey maps can guide the development of tailored interventions to improve treatment outcomes.