Deciding to Enrol in a Cancer Trial: A Systematic Review of Qualitative Studies.
advanced cancer
consolidated framework for implementation research
guideline development
qualitative
Journal
Journal of multidisciplinary healthcare
ISSN: 1178-2390
Titre abrégé: J Multidiscip Healthc
Pays: New Zealand
ID NLM: 101512691
Informations de publication
Date de publication:
2020
2020
Historique:
received:
05
06
2020
accepted:
01
09
2020
entrez:
5
11
2020
pubmed:
6
11
2020
medline:
6
11
2020
Statut:
epublish
Résumé
Clinical trials are essential for the advancement of cancer treatments; however, participation by patients is suboptimal. Currently, there is a lack of synthesized qualitative review evidence on the patient experience of trial entry from which to further develop decision support. The aim of this review is to synthesise literature reporting experiences of participants when deciding to enrol in a cancer clinical trial in order to inform practice. A systematic review and meta-synthesis of qualitative studies were conducted to describe the experiences of adult cancer patients who decided to enrol in a clinical trial of an anti-cancer treatment. Forty studies met eligibility criteria for inclusion. Three themes were identified representing the overarching domains of experience when deciding to enrol in a cancer trial: 1) need for trial information; (2) trepidation towards participation; and (3) justifying the decision. The process of deciding to enrol in a clinical trial is one marked by uncertainty, emotional distress and driven by the search for a cure. Findings from this review show that decision support modelled by shared decision-making and the quality of a shared decision needs to be accompanied by tailored or personalised psychosocial and supportive care. Although the decision process bears similarities to theoretical processes outlined in decision-making frameworks, there are a lack of supportive interventions for cancer patients that are adapted to the clinical trial context. Theory-based interventions are urgently required to support the specific needs of patients deciding whether to participate in cancer trials.
Sections du résumé
BACKGROUND
BACKGROUND
Clinical trials are essential for the advancement of cancer treatments; however, participation by patients is suboptimal. Currently, there is a lack of synthesized qualitative review evidence on the patient experience of trial entry from which to further develop decision support. The aim of this review is to synthesise literature reporting experiences of participants when deciding to enrol in a cancer clinical trial in order to inform practice.
METHODS
METHODS
A systematic review and meta-synthesis of qualitative studies were conducted to describe the experiences of adult cancer patients who decided to enrol in a clinical trial of an anti-cancer treatment.
RESULTS
RESULTS
Forty studies met eligibility criteria for inclusion. Three themes were identified representing the overarching domains of experience when deciding to enrol in a cancer trial: 1) need for trial information; (2) trepidation towards participation; and (3) justifying the decision. The process of deciding to enrol in a clinical trial is one marked by uncertainty, emotional distress and driven by the search for a cure.
CONCLUSION
CONCLUSIONS
Findings from this review show that decision support modelled by shared decision-making and the quality of a shared decision needs to be accompanied by tailored or personalised psychosocial and supportive care. Although the decision process bears similarities to theoretical processes outlined in decision-making frameworks, there are a lack of supportive interventions for cancer patients that are adapted to the clinical trial context. Theory-based interventions are urgently required to support the specific needs of patients deciding whether to participate in cancer trials.
Identifiants
pubmed: 33149597
doi: 10.2147/JMDH.S266281
pii: 266281
pmc: PMC7603415
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
1257-1281Informations de copyright
© 2020 Viljoen et al.
Déclaration de conflit d'intérêts
Dr. Nicholas Ralph reports grants from Australian and New Zealand Urogenital and Prostate Cancer Trials Group, during the conduct of the study; fees from 3M Healthcare, outside the submitted work. The authors have declared no other potential conflicts of interest for this work.
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