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

Abstract

Introduction 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.