Conservation Des Medicaments Thermosensibles Par Les Patients a Domicile

Abstract

The cold chain of thermosensitive drugs is a critical parameter ensuring their therapeutic efficacy and patient safety. While this circuit is strictly controlled by healthcare professionals from manufacturing to dispensing, it becomes particularly vulnerable once the treatment is handed over to the patient. At home, storage depends exclusively on the patient's knowledge and habits. This study aims to explore and evaluate the compliance of home storage practices among ambulatory oncology patients. Methods: This is a descriptive cross-sectional study conducted over a 3-month period (February to April 2026) at the Anticancer Center (CAC) of Sétif. A sample comprising 105 cancer patients undergoing thermosensitive treatment was established. Data were collected using a structured 17-item questionnaire administered face-to-face by the investigator, and subsequently analyzed statistically. Results: The study population is predominantly over 45 years of age (61.9%) with an illiteracy rate of 42.9%. A major gap appears between the information transmitted and received (81.9% of patients) and its actual clarity (only 47.6% consider it clear). Regarding domestic storage, although 81% use the main refrigerator, 48.3% mistakenly place the medication in the door (the most thermally unstable zone), leading to an overall refrigerator placement non-compliance rate of 56.4%. Transport conditions are alarming: only 36.2% use an insulated bag with an ice pack, while an equivalent percentage (36.2%) transports their treatment without any thermal protection. Furthermore, when faced with a thermal doubt, 40.5% of patients administer the product without professional advice. Cross-analysis demonstrates that a university education level and younger age (< 30 years) are significantly associated with the most compliant profiles. Discussion:11 The results highlight that merely providing theoretical information is not enough to guarantee proper practical application at home. Placement errors (refrigerator door) expose these expensive treatments to temperature variations outside the regulatory ranges (+2°C to +8°C). This lack of compliance, accentuated in elderly patients or those with a low level of education, can be explained by a low level of health literacy or by chemotherapy-related cognitive impairment (chemobrain). Moreover, the high rate of treatment administration despite doubt directly exposes the patient to a risk of invisible underdosing and therapeutic failure. It is imperative to move beyond the standard information model to establish genuine therapeutic patient education (TPE) focused on practical demonstration. Conclusion: There is a concerning gap between the theoretical recommendations for storing thermosensitive drugs and the reality of home practices. While patients generally have the reflex to refrigerate their treatments, two stages pose a problem: inadequate thermal transport between the pharmacy/hospital and home, and incorrect placement within the refrigerator (inappropriate storage in the door). These errors do not stem from a lack of information, but rather from a poor practical understanding of the instructions. This is often linked to low health literacy, exacerbated by advanced age, education level, and sometimes the cognitive effects of the treatments (chemobrain). This reinforces the need for active therapeutic education (such as the teach-back method and visual aids).