Impact of Oncology Patients’ Knowledge and Awareness on Emergency Visits and Hospital Admissions: A Cross-Sectional Study

Nada Alsuhebany,1– 3 Shuroug A Alowais,1– 3 Waad Saleh Alanazi,1 Taif Z Alanazi,1 Sarah Ibrahim Aldaghreer,1 Bashayer Alshehri,3 Nadin Almosnid,2,4 Salwa Y Hafez,5,6 Lama Alfehaid,1– 3 Mashael Almuqrin,3 Khalid Al Sulaiman,1– 3,7 Khalid A Alamer,8 Ibrahim M Asiri91Department of Pharmacy Practice, College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 3Department of Pharmaceutical Care, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia; 4Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 5Faculty of Pharmaceutical Sciences, College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 6King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; 7Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia; 8Department of Pharmacy Practice, College of Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 9Saudi Food and Drug Authority, Riyadh, Saudi ArabiaCorrespondence: Nada Alsuhebany, Department of Pharmacy Practice, College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, 2915 Al Haras Al Watani St, Ar Rimayah, Riyadh, 14611, Saudi Arabia, Tel +966-114294455; +966-114295072, Email nalsuhebany@gmail.com; suhebanyn@ksau-hs.edu.saIntroduction: Chemotherapy remains a cornerstone of cancer treatment, but is frequently accompanied by adverse effects that can affects patients’ quality of life. In Saudi Arabia, patients’ understanding of chemotherapy regimens and related toxicities is not well characterized. This study aimed to evaluate chemotherapy awareness among cancer patients and examine its association with hospital admissions and emergency department (ED) visits.Methods: This cross-sectional descriptive study was conducted at a tertiary hospital in Saudi Arabia, between year of 2022 to 2023. Adult cancer patients receiving at least one chemotherapy cycle were interviewed using a validated, investigator-developed questionnaire assessing beliefs and knowledge about cancer diagnosis, treatment regimens, and side effects. Awareness levels were classified as highly aware or not/low aware based on self-reports verified against electronic medical records (EMR). Descriptive statistics summarized demographic characteristics, while independent t-tests compared mean awareness scores between groups. Negative binomial regression examined associations between awareness levels, hospital admissions, and ED visits, adjusting for demographic covariates, with a sensitivity analysis additionally adjusting for advanced (stage IV) disease.Results: A total of 270 participants were enrolled (mean age 52 years; 61.1% female). Breast (33.7%) was the most common diagnosis, with 48.1% at stage IV disease. Overall, 69.3% of patients were classified as highly aware. Highly aware patients demonstrated significantly greater knowledge of treatment goals, chemotherapy regimens, and side effects. Greater awareness was associated with higher rates of ED visits and hospital admissions in adjusted analyses. Female gender and limited English fluency were also significant predictors of higher hospital admissions.Conclusion: Most oncology patients demonstrated high awareness of their chemotherapy. Awareness was not independently associated with emergency visits or hospital admissions; instead, female gender and limited English proficiency were the principal correlates of higher utilization. Structured patient education is needed to translate awareness into effective self-management and reduce healthcare utilization.Keywords: awareness, knowledge, chemotherapy, adverse events, Saudi Arabia