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Lond B, Dodd C, Davey Z, Darlison L, McPhelim J, Rawlinson J, Williamson I, Merriman C, Waddington F, Bagnallainslie D, Rajendran B, Usman J, Henshall C. A systematic review of the barriers and facilitators impacting patient enrolment in clinical trials for lung cancer. Eur J Oncol Nurs 2024; 70:102564. [PMID: 38554615 DOI: 10.1016/j.ejon.2024.102564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Clinical research trials are needed to enhance the medical care and treatment for lung cancer, which remains the leading cause of cancer-related deaths worldwide. While clinical trials allow for the development of novel therapies to treat cancer, the recruitment of lung cancer patients to trials is low. This review aimed to identify and synthesise the available literature concerning barriers and facilitators affecting lung cancer patients' decisions to enrol in clinical trials to guide future cancer research efforts. METHODS Four databases were systematically searched: Academic Search Complete, CINHAL, PubMed, and PsycINFO in August 2023. A supplemental grey literature search was also conducted alongside this. Articles were quality appraised using CASP and JMI checklists, and results were narratively synthesised. RESULTS Eighteen articles of varied design met the inclusion criteria, and results were mapped onto the Capability, Opportunity, and Motivation Behaviour (COM-B) Model to help structure and conceptualise review findings. Evidence suggests that the decision to enrol in a trial is multifaceted and informed by: when and how study information is presented, travel and trial eligibility, and altruistic hopes and fears. CONCLUSIONS There is need to address the many different concerns that lung cancer patients have about participating in a clinical trial through the supply of accessible and timely trial information, and via the reduction of travel, expansion of study eligibility criteria, and recognition of a person's altruistic wishes, hopes, fears, and family-oriented concerns. Future research should aim to work alongside lung cancer patients, clinicians, and other stakeholders to increase research accessibility.
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Affiliation(s)
- Benjamin Lond
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom.
| | - Christopher Dodd
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Zoe Davey
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Liz Darlison
- University Hospitals of Leicester, The Glenfield Hospital, Leicester, United Kingdom
| | - John McPhelim
- University Hospital Hairmyres, NHS Lanarkshire, East Kilbride, United Kingdom
| | - Janette Rawlinson
- Lung Cancer Patient Advisory Group, European Lung Foundation, Sheffield, United Kingdom; British Thoracic Oncology Group Steering Committee, Leicester, United Kingdom
| | - Iain Williamson
- Division of Psychology, De Montfort University, Leicester, United Kingdom
| | - Clair Merriman
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom; Oxford University Hospital Foundation Trust, Oxford, United Kingdom
| | - Francesca Waddington
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | | | - Balaji Rajendran
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | - Jesse Usman
- Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
| | - Catherine Henshall
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom; Oxford Health NHS Foundation Trust, The Warneford Hospital, Oxford, United Kingdom
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Wong CHL, Wong W, Lin WL, Au DKY, Wu JCY, Leung TH, Wu IXY, Chung VCH. Prioritizing Chinese medicine clinical research questions in cancer palliative care from patient and caregiver perspectives. Health Expect 2021; 24:1487-1497. [PMID: 34107142 PMCID: PMC8369121 DOI: 10.1111/hex.13289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/14/2021] [Accepted: 05/12/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Chinese medicine (CM) modalities, including acupuncture and Chinese herbal medicine (CHM), are popular palliative interventions among patients with cancer, but further clinical research is required to assess their effectiveness and safety. OBJECTIVE To prioritize top ten important CM clinical research questions from patients with cancer, cancer survivors and caregivers' perspectives via a face-to-face prioritization workshop in Hong Kong. METHODS A list of 25 CM clinical research questions for cancer palliative care, which were identified from existing systematic reviews (SRs) and overview of SRs, was presented to 17 participants (patients with cancer [n = 5], cancer survivors [n = 6] and caregivers [n = 6]). The participants were then invited to establish consensus on prioritizing top ten research questions. RESULTS Among the top ten priorities, five (50%) focused on acupuncture and related therapies, while five (50%) were on CHM. The three most important research priorities were (i) manual acupuncture plus opioids for relieving pain; (ii) CHM for improving quality of life among patients receiving chemotherapy; and (iii) concurrent use of CHM plus loperamide for reducing stomatitis. CONCLUSION The top ten participant-endorsed CM clinical research priorities for cancer palliative care can guide local researchers on future direction. They can also inform local research funders on patient-centred allocation of limited funding. Under limited research funding, the most important co-prioritized research question from professional and patient perspectives may be addressed first. PATIENT OR PUBLIC CONTRIBUTION Patients with cancer, cancer survivors and caregivers participated in conduct of the study to prioritize CM clinical research questions.
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Affiliation(s)
- Charlene H. L. Wong
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongShatinHong Kong
- Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongShatinHong Kong
| | - Wendy Wong
- National Institution of TCM Constitution and Preventive MedicineBeijing University of Chinese MedicineBeijingChina
- Yat Hei Hong Kong Company LimitedCentralHong Kong
| | - Wai Ling Lin
- Hong Kong Institute of Integrative MedicineThe Chinese University of Hong KongShatinHong Kong
| | - David K. Y. Au
- Hong Kong Institute of Integrative MedicineThe Chinese University of Hong KongShatinHong Kong
| | - Justin C. Y. Wu
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongShatinHong Kong
| | - Ting Hung Leung
- Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongShatinHong Kong
- School of Chinese MedicineThe Chinese University of Hong KongShatinHong Kong
| | - Irene X. Y. Wu
- Department of Epidemiology and Health StatisticsXiangya School of Public HealthCentral South UniversityChangshaChina
| | - Vincent C. H. Chung
- Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongShatinHong Kong
- School of Chinese MedicineThe Chinese University of Hong KongShatinHong Kong
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Harrington RL, Hanna ML, Oehrlein EM, Camp R, Wheeler R, Cooblall C, Tesoro T, Scott AM, von Gizycki R, Nguyen F, Hareendran A, Patrick DL, Perfetto EM. Defining Patient Engagement in Research: Results of a Systematic Review and Analysis: Report of the ISPOR Patient-Centered Special Interest Group. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:677-688. [PMID: 32540224 DOI: 10.1016/j.jval.2020.01.019] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 01/17/2020] [Accepted: 01/30/2020] [Indexed: 05/13/2023]
Abstract
OBJECTIVES Lack of clarity on the definition of "patient engagement" has been highlighted as a barrier to fully implementing patient engagement in research. This study identified themes within existing definitions related to patient engagement and proposes a consensus definition of "patient engagement in research." METHODS A systematic review was conducted to identify definitions of patient engagement and related terms in published literature (2006-2018). Definitions were extracted and qualitatively analyzed to identify themes and characteristics. A multistakeholder approach, including academia, industry, and patient representation, was taken at all stages. A proposed definition is offered based on a synthesis of the findings. RESULTS Of 1821 abstracts identified and screened for eligibility, 317 were selected for full-text review. Of these, 169 articles met inclusion criteria, from which 244 distinct definitions were extracted for analysis. The most frequently defined terms were: "patient-centered" (30.5%), "patient engagement" (15.5%), and "patient participation" (13.4%). The majority of definitions were specific to the healthcare delivery setting (70.5%); 11.9% were specific to research. Among the definitions of "patient engagement," the most common themes were "active process," "patient involvement," and "patient as participant." In the research setting, the top themes were "patient as partner," "patient involvement," and "active process"; these did not appear in the top 3 themes of nonresearch definitions. CONCLUSION Distinct themes are associated with the term "patient engagement" and with engagement in the "research" setting. Based on an analysis of existing literature and review by patient, industry, and academic stakeholders, we propose a scalable consensus definition of "patient engagement in research."
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Affiliation(s)
| | - Maya L Hanna
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT USA
| | | | - Rob Camp
- Community Advisory Board Programme, EURORDIS, Barcelona, Spain
| | | | - Clarissa Cooblall
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
| | - Theresa Tesoro
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
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Martineau JT, Minyaoui A, Boivin A. Partnering with patients in healthcare research: a scoping review of ethical issues, challenges, and recommendations for practice. BMC Med Ethics 2020; 21:34. [PMID: 32393230 PMCID: PMC7216517 DOI: 10.1186/s12910-020-0460-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partnering with patients in healthcare research now benefits from a strong rationale and is encouraged by funding agencies and research institutions. However, this new approach raises ethical issues for patients, researchers, research professionals and administrators. The main objective of this review is to map the literature related to the ethical issues associated with patient partnership in healthcare research, as well as the recommendations to address them. Our global aim is to help researchers, patients, research institutions and research ethics boards reflecting on and dealing with these issues. METHODS We conducted a scoping review of the ethical issues and recommendations associated with partnering with patients in healthcare research. After our search strategy, 31 peer reviewed articles published between 2007 and 2017 remained and were analyzed. RESULTS We have identified 58 first-order ethical issues and challenges associated with patient partnership in research, regrouped in 18 second-order ethical themes. Most of the issues are transversal to all phases and stages of the research process and a lot of them could also apply to patient-partnership in other spheres of health, such as governance, quality improvement, and education. We suggested that ethical issues and challenges of partnered research can be related to four ethical frameworks: 1) Research ethics; 2) Research integrity; 3) Organizational ethics, and 4) Relational ethics. CONCLUSIONS We have identified numerous ethical issues associated with the recent approach of patient-partnership in research. These issues are more diverse than the issues associated with a more traditional research approach. Indeed, the current discussion on how we address ethical issues in research is anchored in the assumption that patients, as research participants, must be protected from risk. However, doing research with, and not on, the patient involves changes in the way we reflect on the ethical issues associated with this approach to research. We propose to broaden the ethical discussion on partnered research to not only rely on a research ethics framework, but to also frame it within the areas of research integrity, organizational ethics and relational ethics.
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Affiliation(s)
- Joé T Martineau
- Department of Management, HEC Montreal, 3000 chemin de la Cote-Ste-Catherine, Montreal, QC, H3T2A7, Canada.
| | | | - Antoine Boivin
- Canada Research Chair in Patient and Public Partnership, CHUM Research Center (CRCHUM) and University of Montreal, Montreal, Canada
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Islam KM, Deviany PE, Anggondowati T, Ryan JE, Fetrick A, Bagenda D, Copur MS, Tolentino A, Vaziri I, McKean HA, Dunder S, Gray JE, Huang CMD, Ganti AK. Patient-Defined Treatment Success: Perspectives of Patients With Advanced-Stage Lung Cancer. J Oncol Pract 2019; 15:e758-e768. [PMID: 31322990 DOI: 10.1200/jop.18.00734] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In the United States, lung cancer accounts for 14% of cancer diagnoses and 28% of cancer deaths annually. Because no cure exists for advanced lung cancer, the primary treatment goal is to prolong survival. OBJECTIVES The study aim was to determine whether individual preferences, characteristics, and treatment experiences affect the meaning of treatment success. MATERIALS AND METHODS A quantitative study using an observational, longitudinal cohort of patients with advanced stage non-small-cell lung cancer was conducted. Data sources included medical records and patient interviews. Data were analyzed using χ2, Fisher's exact, and McNemar's tests, as well as logistic regressions. RESULTS At the first interview of 235 individuals, 12% considered survival alone as their definition of treatment success; others defined treatment success as survival plus other aspects, such as quality of life and reaching an important personal goal. As they moved through chemotherapy, 47% of the patients changed their definition of treatment success. Bivariate analysis showed that patients with lower incomes tended to be more likely to change their definition of treatment success compared with their counterparts with higher income (P = .0245). CONCLUSION By taking chemotherapy, patients expect to increase their odds of survival and want to maintain the quality of life and functionality. A patient's definition of treatment success is often changing as treatment continues, making it appropriate to ensure patient-provider communication throughout their clinical care. The study results are limited to patients with advanced non-small-cell lung cancer and drawn from a predominantly white patient population, mainly from the US Midwest.
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Affiliation(s)
- K M Islam
- Augusta University Georgia Medical College, Augusta, GA
| | - Poppy E Deviany
- University of Nebraska Medical Center College of Public Health, Omaha, NE
| | | | | | - Ann Fetrick
- University of Nebraska Medical Center College of Public Health, Omaha, NE
| | - Danstan Bagenda
- University of Nebraska Medical Center College of Medicine, Omaha, NE
| | | | - Addison Tolentino
- Avera Cancer Institute, Sioux Falls, SD.,St Luke's Hospital of Kansas City, Kansas City, MO
| | | | | | | | | | - Chao M D Huang
- Kansas City VA Medical Center-Kansas City Veterans Administration Health Care System, Kansas City, MO
| | - Apar Kishor Ganti
- University of Nebraska Medical Center College of Medicine, Omaha, NE.,Omaha VA Medical Center-Nebraska-Western Iowa Veterans Administration Health Care System, Omaha, NE
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6
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Pii KH, Schou LH, Piil K, Jarden M. Current trends in patient and public involvement in cancer research: A systematic review. Health Expect 2018; 22:3-20. [PMID: 30378234 PMCID: PMC6351419 DOI: 10.1111/hex.12841] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/27/2018] [Accepted: 09/16/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Patient and public involvement (PPI) in health research is on the rise worldwide. Within cancer research, PPI ensures that the rapid development of medical and technological opportunities for diagnostics, treatment and care corresponds with the needs and priorities of people affected by cancer. An overview of the experiences, outcomes and quality of recent PPI in cancer research would provide valuable information for future research. OBJECTIVE To describe the current state of PPI in cancer research focusing on the research stages, applied methods, stated purposes and outcomes, and challenges and recommendations. METHODS A search was conducted on PubMed, CINAHL and PsycINFO for literature published from December 2006 to April 2017. Original research studies describing the involvement of cancer patients, stakeholders and carers as active partners at any stage of the research process were included. RESULTS Twenty-seven studies were included, the majority reporting PPI at the early stages of research, that is, during the definition and prioritization of research topics and the development of recruitment strategies. Few studies reported PPI at later stages and across the research process. Challenges and recommendations were only briefly described, and critical reflection on the PPI process was lacking. CONCLUSION PPI needs to be integrated more broadly in the cancer research process. The quality of reporting PPI should be strengthened through greater critical reflections including both positive and negative experiences of the PPI process. This will contribute to the further development of PPI and its potential in cancer research.
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Affiliation(s)
- Kathrine Hoffmann Pii
- Institute of Nursing and Nutrition, Copehagen University College, Copenhagen, Denmark
| | - Lone Helle Schou
- Institute of Nursing and Nutrition, Copehagen University College, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark.,Department of Public Health, Aarhus University, Denmark
| | - Mary Jarden
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Bridges JFP, Janssen EM, Ferris A, Dy SM. Project Transform: engaging patient advocates to share their perspectives on improving research, treatment and policy. Curr Med Res Opin 2018; 34:1755-1762. [PMID: 29429378 DOI: 10.1080/03007995.2018.1440199] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Incorporating the patient perspective into lung cancer research, policy and treatment is becoming increasingly recognized as important. This project sought to create an engagement partnership with lung cancer patient advocates and to explore their views on transforming lung cancer healthcare systems, treatment and policy to be more patient centered. METHODS A patient action committee (PAC) of patient advocates living with lung cancer was engaged through group meetings, in-person and phone interviews, and email correspondence. Group meetings (two 1 hour meetings, one 3 hour meeting) served to discuss engagement strategies and project goals, while individual interviews (n = 19) (30-75 minutes) provided in-depth exploration of individuals' perspectives. Meetings and interviews were recorded to identify priorities for addressing issues within lung cancer research, treatment and policy. PAC members corroborated the results through email and in-person meetings. RESULTS PAC members identified three general objectives: (i) for healthcare systems, increasing access to care through accessible, coordinated and affordable care, (ii) for treatment, addressing patient needs in treatment and research through patient education, shared decisions and clinical trials, and (iii) for policy, shining a light on lung cancer through screening policies, public awareness and research funding. CONCLUSION Patient advocates expressed their views that lung cancer is a neglected disease that is not highly prioritized in healthcare systems, treatment approaches and public perceptions. This project represents an integral step in developing an ongoing partnership between researchers and these advocates.
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Affiliation(s)
- John F P Bridges
- a Department of Health Policy and Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
- b Department of Health Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Ellen M Janssen
- a Department of Health Policy and Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | | | - Sydney M Dy
- a Department of Health Policy and Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
- d Department of Medicine , Johns Hopkins School of Medicine , Baltimore , MD , USA
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Chhatre S, Jefferson A, Cook R, Meeker CR, Kim JH, Hartz KM, Wong YN, Caruso A, Newman DK, Morales KH, Jayadevappa R. Patient-centered recruitment and retention for a randomized controlled study. Trials 2018; 19:205. [PMID: 29587805 PMCID: PMC5870194 DOI: 10.1186/s13063-018-2578-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 03/09/2018] [Indexed: 11/17/2022] Open
Abstract
Background Recruitment and retention strategies for patient-centered outcomes research are evolving and research on the subject is limited. In this work, we present a conceptual model of patient-centered recruitment and retention, and describe the recruitment and retention activities and related challenges in a patient-centered comparative effectiveness trial. Methods This is a multicenter, longitudinal randomized controlled trial in localized prostate cancer patients. Results We recruited 743 participants from three sites over 15 months period (January 2014 to March 2015), and followed them for 24 months. At site 1, of the 773 eligible participants, 551 (72%) were enrolled. At site 2, 34 participants were eligible and 23 (68%) enrolled. Of the 434 eligible participants at site 3, 169 (39%) enrolled. We observed that strategies related to the concepts of trust (e.g., physician involvement, ensuring protection of information), communication (e.g., brochures and pamphlets in physicians’ offices, continued contact during regular clinic visits and calling/emailing assessment), attitude (e.g., emphasizing the altruistic value of research, positive attitude of providers and research staff), and expectations (e.g., full disclosure of study requirements and time commitment, update letters) facilitated successful patient recruitment and retention. A stakeholders’ advisory board provided important input for the recruitment and retention activities. Active engagement, reminders at the offices, and personalized update letters helped retention during follow-up. Usefulness of telephone recruitment was site specific and, at one site, the time requirement for telephone recruitment was a challenge. Conclusions We have presented multilevel strategies for successful recruitment and retention in a clinical trial using a patient-centered approach. Our strategies were flexible to accommodate site-level requirements. These strategies as well as the challenges can aid recruitment and retention efforts of future large-scale, patient-centered research studies. Trial registration Clinicaltrials.gov, ID: NCT02032550. Registered on 22 November 2013.
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Affiliation(s)
- Sumedha Chhatre
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St. Suite 4051, Philadelphia, PA, 19104, USA.
| | - Ashlie Jefferson
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ratna Cook
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Caitlin R Meeker
- Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Ji Hyun Kim
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Yu-Ning Wong
- Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Adele Caruso
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane K Newman
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Knashawn H Morales
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ravishankar Jayadevappa
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.,Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
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9
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Patient engagement in research with older adults with cancer. J Geriatr Oncol 2017; 8:391-396. [DOI: 10.1016/j.jgo.2017.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/27/2017] [Accepted: 05/24/2017] [Indexed: 01/11/2023]
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10
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Prioritizing the patient voice in the development of urologic oncology research. Urol Oncol 2017; 35:548-551. [PMID: 28688774 DOI: 10.1016/j.urolonc.2017.06.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/06/2017] [Accepted: 06/12/2017] [Indexed: 11/21/2022]
Abstract
Prioritization of patient and stakeholder engagement in the research process has been realized through increased funding and policy directives at the government level. Particularly, patient engagement in the preparatory research stage has driven development of patient-prioritized research questions. In this article, a successful example of patient-centered research prioritization is reviewed, and effective strategies and opportunities for patient engagement in urologic oncology research are described.
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11
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Rocque GB, Halilova KI, Varley AL, Williams CP, Taylor RA, Masom DG, Wright WJ, Partridge EE, Kvale EA. Feasibility of a Telehealth Educational Program on Self-Management of Pain and Fatigue in Adult Cancer Patients. J Pain Symptom Manage 2017; 53:1071-1078. [PMID: 28185891 PMCID: PMC8641243 DOI: 10.1016/j.jpainsymman.2016.12.345] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/12/2016] [Accepted: 12/29/2016] [Indexed: 02/08/2023]
Abstract
CONTEXT Pain and fatigue are common symptoms among cancer patients and often lead to substantial distress. Innovative self-management programs for pain and fatigue are needed. OBJECTIVES The primary objective was to assess the feasibility of a telehealth pain and fatigue self-management program among adult cancer patients. Secondary objectives included assessment of differences in patient characteristics, recruitment, and retention of patients based on two screening strategies: 1) navigator-collected, patient-reported pain or fatigue and 2) in-clinic, physician-identified pain or fatigue. METHODS This prospective, nonrandomized, pre-post evaluation assessed feasibility, which was defined as 50% of eligible patients choosing to participate and completing the intervention. Patient demographics and patient-reported outcomes (patient activation, distress, symptoms, and quality of life) were collected at baseline and study completion. Differences in baseline characteristics were compared between cohorts and for patients who did vs. did not graduate from the program. RESULTS The program did not meet feasibility requirements because of only 34% of eligible patients choosing to participate. However, 50% of patients starting the program graduated. Differences in baseline characteristics and retention rates were noted by recruitment strategy. At baseline, 27.3% of navigated patients were at the highest activation level compared with 7.1% in the physician-referred, non-navigated patients (P = 0.17); more than 15% of non-completers were at the lowest activation level compared with 9% of completers (P = 0.85). CONCLUSION Telehealth self-management program for pain and fatigue may be better accepted among selected segments of cancer patients. Larger scale studies are needed to assess the efficacy of this program in a more selective activated population.
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Affiliation(s)
- Gabrielle B Rocque
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA; Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
| | - Karina I Halilova
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Allyson L Varley
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Courtney P Williams
- Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Richard A Taylor
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | | | - Edward E Partridge
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Elizabeth A Kvale
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA; Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
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12
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Newhouse RP, Johantgen M, Thomas SA, Trocky NM, Dennison-Himmelfarb C, Cheon J, Miller W, Gray T, Pruitt R. Engaging patients with heart failure into the design of health system interventions: Impact on research methods. Geriatr Nurs 2017; 38:342-346. [PMID: 28228246 DOI: 10.1016/j.gerinurse.2016.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 12/15/2016] [Accepted: 12/19/2016] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to engage patients with heart failure (HF) to assess if changes are needed in a research study design, methods and outcomes when transferring interventions used in urban/community hospitals to rural hospital settings. A qualitative structured interview was conducted with eight patients with a diagnosis of HF admitted to two rural hospitals. Patients validated the study design, measures and outcomes, but identified one area that should be added to the study protocol, symptom experience. Results validated that the intervention, methods and outcomes for the planned study were important, but modifications to the study protocol resulted. Patient engagement in the conceptualization of research is essential to guide patient-centered studies.
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Affiliation(s)
- Robin P Newhouse
- Indiana University School of Nursing, 610 Barnhill Drive, Indianapolis, IN 46202, USA.
| | - Meg Johantgen
- University of Maryland Baltimore, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA
| | - Sue A Thomas
- University of Maryland Baltimore, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA
| | - Nina M Trocky
- University of Maryland Baltimore, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201, USA
| | | | - Jooyoung Cheon
- School of Nursing, Sungshin Women's University, 76ga-gil 55, 01133, Republic of Korea
| | - Wanda Miller
- Riverside Tappahannock Hospital, 618 Hospital Road, Tappahannock, VA 22560, USA
| | - Tracy Gray
- Riverside Tappahannock Hospital, 618 Hospital Road, Tappahannock, VA 22560, USA
| | - Robin Pruitt
- Riverside Shore Memorial Hospital, 9507 Hospital Avenue, Nassawadox, VA 23413, USA
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