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Multiple Myeloma

Oral vs. Physician-Administered Drugs

Yelak Biru identifies similarities and differences between oral and physician-administered drugs, noting that patient-provider relationships are even more crucial when dealing with an oral drug regimen.
Video Library – December 7, 2015
Yelak Biru
Patient, North Texas Myeloma Support Group Leader; Member, International Myeloma Foundation; Advisory Committee Chair, Global Myeloma Action Network

Your question is, "Are the educational needs of patients different for drugs that are administered in the doctor's office versus patients take at their own home?" I would say yes and no at the same time.

Let me answer the no part first. No, in that the patients need to understand these drugs are equally efficacious whether you take them in the doctor's office or you take them at home. Compliance is really important.

There are things that are unique and different in my opinion for orally administered drugs. How do you report side effects, because you don't go to the doctor's office as often as you go for IV administered drugs? You need to find and agree upon with your doctor or your provider how you're reporting side effects.

Physicians also need to make sure they guard against over reporting or under reporting side effects depending on when the side effects occur. If the side effects occur usually close to when you have your appointment, that tends to be the side effect you talk about and you forget some of the major side affects you had earlier in your treatment.

Some of the other things I think are if you miss a dose for example, what do you need to do? For oral drugs that you take on a daily basis, you can take it the next day, but for an oral drug you take once a week, what happens if you miss it now?

Do you still wait for your next dose, or what is the right amount of time to wait and still catch up on your oral dose, before having to wait to the other one? One unique question a colleague of mine brought up about oral drugs that are administered once a week is, "You take oral drugs. You feel sick and you throw up. What happens?"

Because this drug is given to you once a week, you have in practice taken it, but it really is not in your system. At that time, what happens? That means the patient provider relationship is really critical when you actually are taking orally administered drugs.

In my opinion much more so than the drugs that are administered in the physician's office. That relationship is a two‑way trust. As a patient, I need to trust you, you have my back and you are going to advocate on my behalf, and you need to trust me at some point, I have educated myself enough in order for me to have a two‑way dialogue with you as needed.

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Last modified: October 5, 2017

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