Identifying patient values impacting the decision whether to participate in early phase clinical cancer trials: A systematic review.


Journal

Cancer treatment reviews
ISSN: 1532-1967
Titre abrégé: Cancer Treat Rev
Pays: Netherlands
ID NLM: 7502030

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 18 03 2021
revised: 21 04 2021
accepted: 26 04 2021
pubmed: 10 5 2021
medline: 29 6 2021
entrez: 9 5 2021
Statut: ppublish

Résumé

For many patients with advanced cancer, the decision whether to participate in early phase clinical trials or not is complex. The decision-making process requires an in-depth discussion of patient values. We therefore aimed to synthesize and describe patient values that may affect early phase clinical trial participation. We conducted a systematic search in seven electronic databases on patient values in relation to patients' decisions to participate in early phase clinical cancer trials. From 3072 retrieved articles, eleven quantitative and five qualitative studies fulfilled our inclusion criteria. We extracted ten patient values that can contribute to patients' decisions. Overall, patients who seek trial participation usually report hope, trust, quantity of life, altruism, perseverance, faith and/or risk tolerance as important values. Quality of life and humanity are main values of patients who refuse trial participation. Autonomy and social adherence can be reported by both trial seekers or refusers, dependent upon how they are manifested in a patient. We identified patient values that frequently play a role in the decision-making process. In the setting of discussing early phase clinical trial participation with patients, healthcare professionals need to be aware of these values. This analysis supports the importance of individual exploration of values. Patients that become aware of their values, e.g. by means of interventions focused on clarifying their values, could feel more empowered to choose. Subsequently, healthcare professionals could improve their support in a patients' decision-making process and reduce the chance of decisional conflict.

Sections du résumé

BACKGROUND BACKGROUND
For many patients with advanced cancer, the decision whether to participate in early phase clinical trials or not is complex. The decision-making process requires an in-depth discussion of patient values. We therefore aimed to synthesize and describe patient values that may affect early phase clinical trial participation.
METHODS METHODS
We conducted a systematic search in seven electronic databases on patient values in relation to patients' decisions to participate in early phase clinical cancer trials.
RESULTS RESULTS
From 3072 retrieved articles, eleven quantitative and five qualitative studies fulfilled our inclusion criteria. We extracted ten patient values that can contribute to patients' decisions. Overall, patients who seek trial participation usually report hope, trust, quantity of life, altruism, perseverance, faith and/or risk tolerance as important values. Quality of life and humanity are main values of patients who refuse trial participation. Autonomy and social adherence can be reported by both trial seekers or refusers, dependent upon how they are manifested in a patient.
CONCLUSIONS CONCLUSIONS
We identified patient values that frequently play a role in the decision-making process. In the setting of discussing early phase clinical trial participation with patients, healthcare professionals need to be aware of these values. This analysis supports the importance of individual exploration of values. Patients that become aware of their values, e.g. by means of interventions focused on clarifying their values, could feel more empowered to choose. Subsequently, healthcare professionals could improve their support in a patients' decision-making process and reduce the chance of decisional conflict.

Identifiants

pubmed: 33965892
pii: S0305-7372(21)00065-7
doi: 10.1016/j.ctrv.2021.102217
pii:
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

102217

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

Liza G G van Lent (LGG)

Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. Electronic address: l.vanlent@erasmusmc.nl.

Lea J Jabbarian (LJ)

Department of Psychiatry, Erasmus MC, Rotterdam, the Netherlands.

Jelle van Gurp (J)

Department of IQ Healthcare, Radboud University Medical Centre, Nijmegen, the Netherlands.

Jeroen Hasselaar (J)

Department of Anaesthesiology, Pain & Palliative Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands.

Martijn P Lolkema (MP)

Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.

Julia C M van Weert (JCM)

Department of Communication Science, Amsterdam School of Communication Research (ASCoR) and University of Amsterdam, Amsterdam, the Netherlands.

Carin C D van der Rijt (CCD)

Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.

Maja J A de Jonge (MJA)

Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.

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