Care for patients with cancer and substance use disorders: a qualitative study of oncology team experiences.

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Supportive Care in Cancer Pub Date : 2025-02-04 DOI:10.1007/s00520-025-09181-7

Sachin S Kale, Laura J Rush, Jennifer L Eramo, Mireille Bitangacha, Sadie Chen, Devon K Check, Katie Fitzgerald Jones, Jessica Merlin, Ann Scheck McAlearney

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Abstract

Purpose: Clinical decisions surrounding cancer care can be complicated by co-occurring substance use disorders (SUDs), particularly with respect to pain management and cancer treatment safety. Yet, few studies have examined oncology teams' experiences treating patients with co-occurring cancer and SUDs. We therefore sought to understand the perspectives of oncology team providers regarding the challenges they face when caring for patients with cancer and SUDs.

Methods: We conducted a qualitative study to understand the experiences of clinicians who have provided cancer care to patients with concurrent SUD. Questions about substances used focused mainly on non-prescribed opioids and stimulants. Individual interviews were conducted in March-July 2023 by telephone or videoconference, recorded, transcribed verbatim, and analyzed rigorously using thematic analysis.

Results: Twenty-seven individuals were interviewed (15 physicians, 8 advanced practice providers, 2 registered nurses, and 2 social workers). Specialties included medical oncology, hematology, radiation oncology, and gynecology oncology. We identified four themes representing the challenges oncology teams face when caring for patients with cancer and SUD: (1) patients' unmet social needs; (2) uncertainty about pain management options; (3) implicit biases about patients with SUDs; and( 4) patients' active substance use.

Conclusion: Oncology teams face many challenges when caring for patients with cancer and SUDs. Understanding these challenges is critical and can both inform the design of interventions for patients with cancer and SUD and guide future research.

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护理癌症患者和物质使用障碍：肿瘤团队经验的定性研究。

目的：围绕癌症治疗的临床决策可能会因共同发生的物质使用障碍（sud）而变得复杂，特别是在疼痛管理和癌症治疗安全性方面。然而，很少有研究考察肿瘤团队治疗同时发生癌症和sud的患者的经验。因此，我们试图了解肿瘤团队提供者在照顾癌症和sud患者时所面临的挑战。方法：我们进行了一项定性研究，以了解临床医生为并发SUD患者提供癌症护理的经验。关于使用物质的问题主要集中在非处方阿片类药物和兴奋剂上。于2023年3月至7月通过电话或视频会议进行了个别访谈，逐字记录，并使用专题分析进行严格分析。结果：共访谈27人（医生15人，高级执业医师8人，注册护士2人，社工2人）。专科包括内科肿瘤学、血液学、放射肿瘤学和妇科肿瘤学。我们确定了四个主题，代表肿瘤团队在照顾癌症和SUD患者时面临的挑战：(1)患者未满足的社会需求；(2)疼痛管理方案的不确定性；(3)对sud患者的内隐偏见；(4)患者活性物质使用情况。结论：肿瘤团队在护理癌症和sud患者时面临许多挑战。了解这些挑战是至关重要的，既可以为癌症和SUD患者的干预设计提供信息，也可以指导未来的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.