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Wu L, Smith CB, Parra J, Liu M, Theroux HH, Bhardwaj AS. Upgrading the Chemotherapy Consent: Trading in Paper for Tablet. JCO Oncol Pract 2021; 18:e632-e637. [PMID: 34910564 DOI: 10.1200/op.21.00457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Our institution participated in the Oncology Care Model, which required us to include many of the 13 elements of the National Academy of Medicine (NAM) care plan into care pathways for our patients. We optimized our existing chemotherapy consent process to meet this need and maximized completion. METHODS Our multidisciplinary committee developed a three-phase Plan-Do-Study-Act process in our breast cancer clinic: (1) update and educate providers on our paper chemotherapy form with multiple components of the NAM care plan including prognosis and treatment effects on quality of life; (2) piloted an electronic chemotherapy consent form to decrease the administrative burden; and (3) autopopulated fields within the electronic consent. We assessed feedback after cycle 1 and created a Pareto chart. The outcome measure was percent completion of chemotherapy consent documents. RESULTS Baseline monthly random chart audit of 40 patients revealed 20% of paper chemotherapy consent forms were completed in their entirety among patients. When we re-educated clinicians about the new paper consent containing the NAM elements, compliance rose to nearly 30%. A Pareto chart confirmed that content redundancy and wordiness were leading to under-completion. After creating and piloting the electronic consent, compliance increased to 90%. Finally, autopopulation with drop-down selections increased and sustained completion to 100%. CONCLUSION Incorporating regulatory requirements into an existing workflow using Plan-Do-Study-Act methodology can reduce administrative burden on clinicians. Additional use of innovative technology can further increase clinician compliance with regulatory requirements while delivering high-value quality care to patients with cancer.
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Affiliation(s)
- Lesley Wu
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY
| | - Cardinale B Smith
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jessica Parra
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mark Liu
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Haley Hines Theroux
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Aarti S Bhardwaj
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
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Bleiberg H, Decoster G, de Gramont A, Rougier P, Sobrero A, Benson A, Chibaudel B, Douillard JY, Eng C, Fuchs C, Fujii M, Labianca R, Larsen AK, Mitchell E, Schmoll HJ, Sprumont D, Zalcberg J. A need to simplify informed consent documents in cancer clinical trials. A position paper of the ARCAD Group. Ann Oncol 2017; 28:922-930. [PMID: 28453700 PMCID: PMC5406755 DOI: 10.1093/annonc/mdx050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background In respect of the principle of autonomy and the right of self-determination, obtaining an informed consent of potential participants before their inclusion in a study is a fundamental ethical obligation. The variations in national laws, regulations, and cultures contribute to complex informed consent documents for patients participating in clinical trials. Currently, only few ethics committees seem willing to address the complexity and the length of these documents and to request investigators and sponsors to revise them in a way to make them understandable for potential participants. The purpose of this work is to focus on the written information in the informed consent documentation for drug development clinical trials and suggests (i) to distinguish between necessary and not essential information, (ii) to define the optimal format allowing the best legibility of those documents. Methods The Aide et Recherche en Cancérologie Digestive (ARCAD) Group, an international scientific committee involving oncologists from all over the world, addressed these issues and developed and uniformly accepted a simplified informed consent documentation for future clinical research. Results A simplified form of informed consent with the leading part of 1200-1800 words containing all of the key information necessary to meet ethical and regulatory requirements and 'relevant supportive information appendix' of 2000-3000 words is provided. Conclusions This position paper, on the basis of the ARCAD Group experts discussions, proposes our informed consent model and the rationale for its content.
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Affiliation(s)
| | | | - A. de Gramont
- Department of Medical Oncology, Institut Hospitalier Franco-Britannique, Levallois Perret
| | - P. Rougier
- Gastroenterology and Digestive Oncology Department, European Hospital, Georges Pompidou, Paris, France
| | - A. Sobrero
- Medical Oncology Unit, Ospedale San Martino, Genova, Italy
| | - A. Benson
- Division of Hematology/Oncology, Robert H. Comprehensive Cancer Center Northwestern University, Chicago, USA
| | - B. Chibaudel
- Department of Medical Oncology, Institut Hospitalier Franco-Britannique, Levallois Perret
| | - J. Y. Douillard
- Department of Medical Oncology, Centre R. Gauducheau Université de Nantes, Saint Herblain, France
| | - C. Eng
- Division of Cancer Medicine, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - C. Fuchs
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M. Fujii
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - R. Labianca
- Cancer Center, Ospedale Giovanni XXIII, Bergamo, Italy
| | - A. K. Larsen
- Laboratory of Cancer Biology and Therapeutics, INSERM and Université Pierre et Marie Curie, Saint-Antoine Hospital, Paris, France
| | - E. Mitchell
- Kimmel Cancer Center at Jefferson, Jefferson University Hospitals, Philadelphia, USA
| | - H. J. Schmoll
- Department of Internal Medicine IV, University Clinic Halle, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - D. Sprumont
- Institute of Health Law, University of Neuchâtel, Neuchâtel, Switzerland
| | - J. Zalcberg
- Faculty of Medicine, Nursing and Health Sciences, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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