From Hospital to Home: Patient Experiences With Medication Counselling for Colorectal Cancer

ABSTRACT

Colorectal cancer is a growing global health concern with complex pharmacotherapy, especially as oral anticancer drugs shift responsibility for adherence to patients. This study explores the experiences of colorectal cancer patients in medication counselling in hospitals and community pharmacies. A qualitative study was conducted through semistructured individual interviews with patients with colorectal cancer (N = 21) from a university hospital. Inductive content analysis was performed using ATLAS.ti software, identifying key categories and subcategories. The following five main themes emerged: sufficiency of counselling; medication reconciliation; management of anticancer medication‐related problems; instructions for contacting healthcare; and instructions for medication use. Patients reported varied experiences. Some felt well‐informed and confident, while others found counselling insufficient and needed more support. Discrepancies in medication reconciliation were raised, particularly regarding nutritional and herbal products. The pharmacy's role in medication risk management was highlighted, with some patients' medications adjusted based on pharmacy consultation. While side effect management was generally addressed, some patients wanted more detailed information. Challenges in accessing counselling were highlighted, especially during weekends. Medication counselling for colorectal cancer patients should be more consistent across healthcare settings. Strengthening the role of pharmacies and enhancing collaboration and information flow between hospitals and pharmacies is crucial for achieving better patient outcomes.

Summary

• Experiences of colorectal cancer patients with medication counselling varied, with some feeling well‐informed and others reporting insufficient support and unclear guidance.

• The following five key themes were identified: sufficiency of counselling; medication reconciliation; managing medication‐related problems; instructions for contacting healthcare; and medication usage guidance.

• Community pharmacies played an important role in identifying and managing medication risks (e.g., leading to changes in treatment).

• Access to counselling was inconsistent, particularly during weekends, highlighting the need for better coordination and continuity across healthcare settings.

1. Introduction

Colorectal cancer is increasingly prevalent globally, particularly in Western countries, and is currently the third most common type of cancer worldwide [1]. Concurrently, the use of oral anticancer drugs is on the rise, placing greater responsibility on patients to manage their medications effectively [2]. These orally administered drugs work by killing cancer cells or inhibiting their division [3]. They include chemotherapies, targeted therapies and immunotherapies, all absorbed through the gastrointestinal tract to exert systemic effects. Cancer treatment often involves a complex regimen of multiple drugs, including pre‐ and supportive medications to prevent or manage side effects such as nausea [4, 5]. This complexity poses significant challenges for both patients and healthcare professionals.

Especially home‐based cancer treatment carries a heightened risk of treatment failure, as insufficient guidance, misunderstandings or ambiguities can lead to medication errors [6]. Oral anticancer drugs are classified as high‐risk medicines due to narrow therapeutic windows and severe side effects [7]. Despite these risks, they offer benefits, such as reducing hospital visits and avoiding side effects associated with intravenous drugs [8]. With reduced contact with healthcare professionals, proactive side‐effect management and counselling is becoming increasingly important [9].

Adherence to oral anticancer medicines, particularly in colorectal cancer, can be poor [8], and a lack of support from healthcare professionals exacerbates this issue [10, 11]. Community pharmacies may also face challenges in providing adequate guidance for anticancer medicines, especially with nonstandard or off‐label treatment protocols [6]. However, studies indicate that medication counselling not only improves adherence and reduces treatment discontinuation but also enhances patient satisfaction and lowers the risk of serious side effects when provided by specialised pharmacists [12, 13, 14].

The medication treatment of colorectal cancer is a complex process in which the treatment increasingly falls under the patient's responsibility and is challenging health care. Although research highlights the importance of multidisciplinary counselling [9], the perspectives of colorectal cancer patients regarding the quality and adequacy of the medication counselling they receive remain underexplored. This study aims to investigate the experiences of colorectal cancer patients with the medication counselling provided in hospital and community pharmacy settings, specifically within the context of their care pathway from hospital to home. More specifically, the study seeks to explore patients' perceptions of the content, quality and relevance of the counselling received; to examine how counselling practices across care settings support understanding, self‐management and adherence; and to identify perceived gaps and improvement needs in the continuity and adequacy of counselling along the care pathway.

2. Materials and Methods

2.1. Study Design and Data Collection

The present qualitative interview study was conducted at the outpatient clinic at the Helsinki University Hospital (HUS) Cancer Centre in Finland. The HUS Cancer Centre is Finland's largest cancer treatment centre. It is responsible for the oncological treatment of adult cancer patients in Helsinki and Uusimaa with approximately 25 000 treated patients annually, including 9000 new patients. The HUS Cancer Centre also treats patients who require specialised expertise from other parts of Finland. The patient volume has remained relatively stable in past years, with a modest annual increase of approximately 5%. The present study was part of a larger practice development project that aimed to develop medication counselling for cancer patients in hospitals and community pharmacies in the capital area of Southern Finland [15]. This study concentrated on examining patients' experiences with the medication counselling provided by the healthcare units and community pharmacies involved in the project. This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist, as provided by the EQUATOR Network [16] (Appendix 1).

A semistructured thematic interview framework was constructed to reflect the study objectives and was presented to the patient research panel at the HUS Cancer Centre for feedback. Based on their comments, the framework was finalised. The interview topics and respective questions reported in the present article are listed in Table 1.

TABLE 1.

Topic guide for the interview related to colorectal patient experiences with medication counselling in hospitals and community pharmacies.^*

Experiences with medication counselling: 1. What are your general experiences with the received colorectal cancer medication counselling?

Pharmacotherapy implementation: 2. Where did you receive counselling on how and when to take cancer medications? 3. Did you discuss the possible interactions with your other medications, the use of dietary supplements or the prevention and treatment of side effects with healthcare professionals in the hospital or community pharmacy? 4. What kind of counselling did you receive on monitoring the effects of your pharmacotherapy? 5. Have you used medications differently than prescribed due to insufficient information or other unintentional factors? 6. Was the medication counselling you received from the hospital care unit and the community pharmacy sufficient for you to safely manage your pharmacotherapy?

^*Only the topics and the respective questions related to the present article are listed.

A total of 25 patients diagnosed with colon cancer were recruited from the HUS Cancer Centre for the study. The inclusion criteria were age of 18 years or older, ongoing care relationship in the HUS Cancer Centre, Finnish speaking and the intention to visit the participating community pharmacies in the capital region. The exclusion criteria included being under 18 years of age, having a terminated treatment relationship with the Cancer Centre, lacking proficiency in Finnish, or intending to use a pharmacy outside the Helsinki metropolitan area. Four patients were excluded because they did not meet the inclusion criteria, resulting in a final sample of 21 interviewed patients.

A clinical pharmacist from the HUS Pharmacy was responsible for patient recruitment. Participants were approached in person during their initial hospital visit. Patients had the opportunity to review the forms and sign the consent to participate during the same visit or submit the signed consent form by mail in a prepaid envelope. Recruitment occurred between September 2023 and February 2024, and interviews were conducted shortly after patient's initial visit to HUS Cancer Centre.

2.2. Qualitative Analysis

The semistructured individual interviews were carried out remotely via telephone by one researcher (HT). This interview format was chosen to allow participants to freely share their experiences and perspectives, enabling an in‐depth investigation of a relatively underresearched topic. This approach facilitated a comprehensive understanding of the phenomenon prior to potential quantification in future studies.

The interview topic guide was piloted with three interviewees to ensure its functionality. Because the pilot did not lead to changes in the topic guide, the pilot interviews were included in the analysis. The interviews were audiotaped and transcribed verbatim. The interviews were conducted in parallel with the analysis to ensure data saturation, which was considered achieved when recurring core patterns began to emerge.

Given the limited prior knowledge in the area, inductive qualitative content analysis was conducted using ATLAS.ti software [17]. The present data‐driven approach enabled the systematic identification of patterns and themes in patients' experiences with medication counselling throughout their transition from hospital to home. Subsequently, relevant quotes were identified and coded, and codes with similar meanings were systematically rearranged into subcategories, upper categories and main categories using Version 10 software. The initial coding and analysis were conducted by HT and carefully reviewed collaboratively with the study group. The final analysis was validated by two other researchers (KK and ARH). Any discrepancies were resolved through thorough analysis and discussion until a mutual consensus was reached. HT is a pharmacist working in both hospital and community pharmacy settings. KK and ARH hold PhDs in pharmacy and have prior experience in qualitative research. The researchers collaborated through online meetings, which allowed everyone to share their thoughts, reflect on the research process and take part in the discussion.

2.3. Ethics and Informed Consent

The Ethics Committee of Helsinki University Hospital granted ethical approval (HUS/348/2023) for the study. Participation in the study was voluntary, and the patients were given the opportunity to familiarise themselves with the study before deciding on participation. All participants gave written informed consent. Confidentiality and anonymity were ensured by pseudonymising the data and removing any information that could allow identification of individual participants. The study was conducted in accordance with the Basic & Clinical Pharmacology & Toxicology policy for experimental and clinical studies [18].

3. Results

The characteristics of the participating colorectal patients (N = 21) are presented in Table 2. The times of individual interviews varied from 12 to 46 min.

TABLE 2.

Characteristics of the interviewed colorectal cancer patients (N = 21).

Gender	(n)
Female	9
Male	12
Age
40–50	3
51–60	6
61–69	5
≥ 70	7

In the inductive content analysis, 36 subcategories, 16 upper categories and 5 main categories were identified (Figure 1 presents main and upper categories). The main categories reflected patients' experiences with medication counselling for colorectal cancer. The key areas comprised the experienced sufficiency of the received medication counselling, experiences of medication reconciliation practices, identification of and addressing problems in anticancer drug treatment, the received instructions for contacting healthcare providers and the experienced clarity of the instruction on drug administration.

FIGURE 1.

The identified key areas of colorectal cancer patients' (N = 21) experiences with medication counselling. The main and upper categories are presented based on the analysis.

3.1. Sufficiency of Medication Counselling

The interviews highlighted the patients' general satisfaction with the adequacy of medication counselling and the feeling of trust and safety (Table 3). The patients described being adherent to the prescribed anticancer medications. Some felt there was no need for any other support or guidance, while others described the guidance as insufficient. The patients had experienced uncertainty regarding several aspects of their pharmacotherapy and had to seek additional support to clarify issues related to their medication. Patients also felt a partial responsibility for asking questions.

TABLE 3.

Example citations of colorectal cancer patients' experiences in medication counselling in hospitals and community pharmacies.

Identified key areas (main categories)	Citations
Sufficiency of medication counselling	“You must know to ask if something is unclear [refers to an important medication treatment instruction]. And that must be emphasised” – Man, 77 years old “I have been pleasantly surprised by how well I have been informed.” – Woman, 55 years old “Overall, except for one episode, I have felt good and safe. So, I feel I have received good and relevant care and advice, just as much in community pharmacies as in the hospital.” – Woman, 49 years old “It would have been helpful to double‐check with the pharmacist at the pharmacy to ensure that the important anticancer medication, including the dosage and timing, was clearly understood. It's also important to review the premedications and confirm the details to avoid any confusion.” – Male, 76 years old
Medication reconciliation	“At the pharmacy, they noticed it would have been hazardous to take those [medications] because of the risk of bleeding.” – Male, 59 years old
Management of anticancer medication‐related problems	“My doctor had told me there could be some jaw stiffness and cold sensitivity, so I did not get too scared, even though I wasn't wary enough. After treatment, I drank lukewarm water and lost my ability to speak. It stiffened my jaw in such a way that my husband was quite surprised. I just tried to say it would pass and did not panic. I realised, okay, this is what they warned me about. I knew what was happening, and none of the side effects, not even the strange ones, really scared me. Based on that, I felt I got enough information.” – Woman, 49 years old “What does cold sensitivity really mean, and how many things can it affect? I wish I had been told beforehand that it could cause these kinds of issues and how I could prevent them. Only later did I realise that all the vegetables in the fridge were pretty cold.” – Woman, 44 years old “But the line between whether it's time to react or if it's not a big deal is a bit unclear, like a line drawn in water.” – Male, 68 years old “When we went over the side effects, no one really told me how to prevent them, except one nurse who said, “Better to overdo it than underdo it with the nausea medication,’ which I could take three times a day.” – Woman, 66 years old
Instructions for contacting healthcare	“...I contacted the healthcare unit because they told me I should not take the medication if I had a fever. When I got a fever, I called to ask what to do, and they told me to skip the evening dose.” – Woman, 44 years old “Weekends are confusing because you cannot always reach the right person, and there is also a delay in getting a response. Even the advice line does not always provide help immediately. They told me the response delay could be 2 days. I wish the process would be smoother.” – Woman, 49 years old
Instructions for medication use	“The doctor gave instructions on when to take the medication, how many tablets to take daily, and the timing. The nurse supplemented that with verbal instructions, patient guidelines, general instructions, and the prescriptions provided by the physician. They detailed the physician's instructions very clearly, and I found that very helpful.” – Man, 76 years old “The pharmacy had also printed labels on the medication packages, which was helpful. Moreover, they went over it carefully for capecitabine since taking it exactly twelve hours apart is important.” – Woman, 55 years old

According to some patients, the hospital's medication counselling was comprehensive and sufficient and ensured good care experience. The opportunity to consult a nurse or a physician about uncertainties was significant. However, patients expressed a need for peer support and wished that nurses would also share recommendations based on other patients' experiences. The advice on dietary supplements was found to be inconsistent: some patients discussed nutritional supplements with the nurses and received instructions on their use, while others did not receive such guidance.

Patients reported receiving helpful and knowledgeable advice from the community pharmacy, finding it a good instance for seeking counselling when their medications were dispensed. However, some patients found it challenging to follow verbal counselling at the pharmacy, as they had to rely solely on their memory to recall the instructions. Additionally, some patients felt that the pharmacy's role in medication counselling was not significant in managing their overall treatment. There was also no discussion at the pharmacy about the use of dietary supplements.

In the patients' interviews, two medication errors were identified: one related to dietary supplements and the other to confusion about dosing instructions. One patient, due to a lack of information, had used a prohibited dietary supplement after being diagnosed with cancer. Another patient took a different dose of medication than prescribed. In one instance, a patient read the dosage instructions on the medication's package leaflet and realised that the dosage differed from the general recommendation, leading to confusion. Patients also found it challenging to distinguish between the trade names and active substances, and they believed that these issues would be especially difficult for older patients. They wished for more information about how medications prescribed for side effects function. Additionally, they hoped that healthcare professionals would provide more advice on the correct dosing of medication, especially when using multiple medications for the same condition. Some patients felt that they had not received sufficient counselling regarding dosage.

There were also challenges in receiving and understanding information related to pharmacotherapy. Patients felt that the information was spread across various sources and provided in multiple forms, such as written, verbal and through the online client e‐service portal.

3.2. Medication Reconciliation

During medication reconciliation at the hospital patients were asked about the use of other medications, dietary supplements and natural products (Table 3). A physician, nurse or hospital pharmacist conducted the medication reconciliation. Some patients mentioned that different nurses or physicians reviewed their medication multiple times. In some cases, medication interactions between anticancer medicines and other medicines were discovered during the reconciliation, leading to changes such as discontinuing specific medications or supplements. However, some patients felt that no meaningful discussion followed, although their medications had been reviewed. According to the patients, insufficiently reconciled medication caused interactions, some of which were serious. In some cases, the reconciliation and counselling regarding dietary supplements at the hospital were also insufficient. Some patients reported that discussions about using vitamins or minerals were not part of their reconciliation process.

Patient interviews revealed the significant role of patients' own initiative in ensuring the accuracy of their medication. Patients indicated that they had proactively asked about the compatibility of their regular medications and over‐the‐counter drugs with their cancer treatments. Some the discussion about supplements and their use only occurred because they initiated it. To ensure the accuracy and appropriateness of their medication, patients also turned to the pharmacy for advice.

3.3. Management of Anticancer Medication‐Related Problems

Patients reported receiving information about side effects related to anticancer drug therapy, such as diarrhoea, chest pain, hand‐foot syndrome and sensitivity to cold (Table 3). Some patients felt that there were no side effects during their cancer treatment that they had not been warned about in advance. One patient experienced cold sensitivity and felt adequately informed beforehand, and therefore found the situation unalarming. However, another patient felt the opposite that she had not been given enough counselling about the side effects of cold sensitivity.

Written instructions provided extensive information about potential problems with anticancer drug therapy and their management. However, some patients either could not identify or did not remember the guidance they had received for recognising potential treatment problems. Patients found it challenging to consider the severity of problems, which made it difficult to know when to seek help.

Patients indicated that nurses and physicians at the hospital had discussed preventing and managing side effects of anticancer drug therapy, and they had received written instructions as well. They were given guidance on how to manage side effects, either with medication or by pausing cancer treatment. Some patients reported being informed about the side effects but not given advice on how to prevent them. Others felt that no discussions about preventing or treating side effects had occurred. There was also a desire for more counselling on neuropathy symptoms. Pharmacies guidance on side effects was limited to prescription medications.

Regarding problems with anticancer drug therapy, patients were instructed to monitor the effects of their treatment using both written and digital tools (such as patient diaries and symptom questionnaires). Blood pressure was one of the indicators patients were told to monitor, whereas a desire for receiving more information about tracking blood values was expressed.

3.4. Instructions for Contacting Healthcare

Some patients reported receiving explicit instructions on when to seek help and counselling and when to contact the healthcare unit (Table 3). Such situations included nonurgent matters even small changes in their condition unusual circumstances where home treatment was ineffective, persistent symptoms or uncertainty about their medication. Patients also received verbal and written instructions on acting in case of severe side effects. In these situations, they were advised to go to the hospital, contact their local health centre, or call emergency services. When seeking emergency care, patients were asked to inform healthcare staff about their anticancer medications. Some patients, however, mentioned that they did not remember receiving instructions or could not recall the guidance they had received about seeking help. While some had not needed to contact their healthcare unit, others reported making contact at least once. Patients called the health care unit to ask about pausing a medication before a procedure or when side effects occurred, and had consequently received instructions.

Patients found it easy to contact their healthcare unit and felt that they received help when reaching out and felt that information was easily accessible by phone. Some found the hospital e‐service portal to be a convenient contact channel. However, some patients expressed feelings of shame if they had contacted the hospital's healthcare unit multiple times. Interviews also highlighted that no help was available on weekends and that response delays, sometimes up to 2 days, caused patient confusion and frustration.

3.5. Instructions for Medication Use

Patients felt they received exact instructions on the use of anticancer medications, including when to take them and how to take them concerning meals (Table 3). They were also provided with written instructions. Patients reported receiving information from both physicians and nurses during their hospital stay. Nurses were seen as complementing the physician's guidance. Medication dosing instructions were given daily, and patients received a patient diary to take home. The diary included information on medication dosage but not how to take the medications. However, patients felt that they received sufficient verbal guidance from the nurses. Overall, patients found the counselling in the hospital adequate, precise, and clear. The internet was also frequently mentioned as a source of information regarding medication use.

On the other hand, some patients felt that while the medication instructions were sufficient, they could have been even more detailed. Patients mentioned a sense of rushing at the hospital and expressed a need for more time to discuss their treatment. Some also felt they had not received much counselling at the hospital or could not remember the guidance they had been given.

Patients further reported counselling at the community pharmacy on how and when to take their medications. Some emphasised the pharmacy's guiding role as more significant than the hospital. They wanted the pharmacy to review dosing instructions to provide additional confidence in following their treatment. However, others felt that they no longer needed further counselling at the pharmacy. Table 3 represents example citations highlighting the results.

4. Discussion

The colorectal cancer patients' experiences with medication counselling varied both in hospital and pharmacy settings. Patients described conflicting experiences regarding the adequacy and content of medication counselling, as well as in medication reconciliation and support received for pharmacotherapy. Similar variability has been observed in other studies concerning cancer patients' experiences with physician communication and care coordination [19]. Despite the challenges identified in this study, patients generally felt satisfied with the competencies and accessibility of hospital staff, feeling secure and well‐informed about their pharmacotherapy. However, a significant barrier to receiving adequate support and counselling in the hospital was the sense of urgency, as also reported in other studies [20, 21]. It is recommended that cancer patients, similar to all patients, be treated with respect, kindness and calmness to facilitate the adjustment to their personal situation and treatment [22].

The differing experiences suggest that colorectal cancer patients may not receive individualised medication counselling that considers their unique characteristics. Factors such as fatigue from the diagnosis and treatment, as well as psychosocial stress, can complicate their understanding of the counselling provided [14, 23, 24]. In this study, patients consulted with a physician immediately after diagnosis to discuss treatment options and participate in decision‐making, which can be mentally challenging but necessary for receiving prompt treatment instructions [25]. Patient‐related factors, such as lacking knowledge and skills, have also been found to affect medication adherence [11]. Differences in information‐seeking behaviour and the need for information may further explain variations in the experiences and are potentially influenced by personality traits or sociodemographic factors [26]. Consequently, health services systems should develop patient‐specific medication counselling for colorectal cancer patients considering their individual needs and challenges in receiving and processing information.

Patients reported receiving thorough and professional counselling at community pharmacies. For some patients, the role of the pharmacy was even described as major for safe pharmacotherapy, while others found the pharmacy's role less important. In many countries, pharmacies have a key responsibility to provide medication counselling [27]. However, international studies highlight challenges faced by pharmacy professionals in counselling cancer patients [6], although patients have found the provided counselling beneficial [12]. According to the interviewees in this study, the community pharmacists often recognised medication interactions, leading to changes in overall medication regimens. Thus, the pharmacy's role as a systemic defence against medication risks should be better recognised and understood as an asset in preventive medication risk management of colorectal cancer patients [28, 29].

A significant medication safety risk identified was the lack of healthcare provider assistance during weekends. Patients experienced uncertainty when encountering medication‐related problems, with response delays of several days. The lack of support negatively impacts patients' adherence to medication [11]. In the absence of support, cancer patients may even independently discontinue anticancer medication due to side effects, potentially leading to treatment failure [30]. In this study, the counselling provided to patients included instructions for emergency situations, advising them to inform emergency healthcare staff about their medication. Such guidance is crucial for medication safety; the risk of medication errors increases when cancer patients require hospitalisation as the errors can occur due to misinterpretations of complex medication regimens [31]. Consequently, providing anticancer medication healthcare assistance that is experienced as accessible during weekends would be an essential target of development.

Despite the weekend challenges, patients appreciated the ability to contact their care unit for medication counselling. Personal contact was crucial for sufficient counselling, but patients sometimes felt ashamed of making multiple contacts. This aligns with Bulls et al. (2019), who found a link between perceived stigma and patient behaviour, particularly among opioid users. Indeed, fear of seeking advice was found to result in poor medication management [30, 32]. While anticancer medications may not carry the same stigma, not asking questions can compromise the entire treatment process [30]. It is crucial to communicate the importance of patient contact in a way that does not exceed healthcare provision capacity but ensures that patients are not hesitating to reach out for advice.

Most patients did not recall any medication errors and reported adhering to medication instructions. These findings diverge from prior literature, which has shown poor adherence to oral anticancer medications among colorectal cancer patients [8]. For some patients inadequate medication reconciliation and counselling led to medication errors. These errors often related to dietary supplements and herbal products and were identified at pharmacies or by patients themselves. Consequently, standardised counselling on these products should be implemented to the treatment process due to their frequent use among cancer patients [33].

The interviews revealed the need to instruct patients about potential off‐label medication use, as patients often independently seek medication information [34]. Discrepancies between official use recommendations and instructions received at the treating unit can lead to medication use contrary to individualised instructions. Pharmacies may also identify off‐label use. However, principles of such exceptional situations may not be familiar to pharmacy professionals and hence appear as medication errors to both the pharmacist and the patient. Such patient experiences can undermine trust in treatment and hinder adherence [11]. This highlights the importance of regional collaboration and organising adequate information flow between community pharmacies and hospitals.

4.1. Strengths and Limitations and Future Perspectives

This study's strength lies in its comprehensive examination of patients' experiences with medication counselling for colorectal cancer throughout the care pathway, from hospital to home. To our knowledge, this is the first study to investigate the entire medication counselling process. Interviews were piloted without needing modifications and recruitment continued until data saturation was achieved.

However, the participants were recruited from only one university hospital in Finland, which may affect the transferability of the results despite the hospital treating approximately 25 000 cancer patients annually. The small sample size and potential memory bias or subjectivity of patients also limit the findings, although efforts such as recruiting patients under current treatment, were made to minimise these biases. Nevertheless, the aim was to explore patients' views and experiences, which are subjective in nature [35]. Limiting the sample to Finnish‐speaking patients may introduce an additional selection bias as it excludes individuals who might have experienced challenges or dissatisfaction with care due to language barriers. The use of telephone interviews may have also limited the richness of the data, as the absence of nonverbal cues could have affected the depth of responses and the interpretation of participants' emotions or intentions. However, the analysis showed that despite face‐to‐face contact, the patients were able to provide in‐depth descriptions on their treatment experiences.

The authors' professional backgrounds in pharmacy may have shaped their interpretation of the findings. While this positionality could influence how certain aspects were emphasised, it also provided valuable insights into the role of pharmacists in the care pathway. Moreover, as the authors represent different sectors of pharmacy (hospital, community and academia), their diverse perspectives helped to enrich the analysis and enhance the credibility of the study. Future development should include integrating pharmacies into the colorectal cancer care pathway and ensuring pharmacy professionals have access to the same patient information as hospitals. This information sharing is crucial for consistent counselling, which enhances patient trust in the treatment process [36]. Local cooperation among care providers is necessary to develop regional models for colorectal cancer treatment. Optimising this model in cancer patient counselling is a key target for future research.

5. Conclusions

The colorectal cancer patients' experiences with anticancer medication counselling vary between hospital and pharmacy settings. There is a particular need to improve the adequacy, consistency and overall content of medication counselling, as well as practices for medication reconciliation and the provision of sufficient support for medication‐related problems. While dietary supplements and herbal products pose interaction and other medication safety risks for cancer patients, it is crucial to prioritise this substance group during medication reconciliation and to increase patient awareness of the risks as a standard part of patient guidance. The role of community pharmacies as an essential component of medication counselling and medication risk management should be recognised within the colorectal cancer care pathway. To achieve this, enhanced regional cooperation between pharmacies and hospitals is essential.

Author Contributions

Conceptualisation: K. K., A. R. H.; formal analysis: H. T., K. K., A. R. H.; investigation: K. K., H. T., A. R. H.; project administration: K. K.; supervision: K. K., A. R. H.; visualisation K. K., H. T., A. R. H.; writing original draft: K. K., A. R. H.; critically review and editing the manuscript: K. K., H. T., A. R. H.. All authors have read and agreed to the published version of the manuscript.

Funding

The authors have nothing to report.

Ethics Statement

This study was performed in line with the principles of the Declaration of Helsinki. The Ethics Committee of Helsinki University Hospital granted ethical approval (HUS/348/2023) for the study.

Consent

Written informed consent was obtained from all individual participants included in the study.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Appendix S1: Supporting Information.

Kvarnström K., Tallqvist H., and Holmström A.‐R., “From Hospital to Home: Patient Experiences With Medication Counselling for Colorectal Cancer,” Basic & Clinical Pharmacology & Toxicology 138, no. 1 (2026): e70180, 10.1111/bcpt.70180.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.