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Enhancing decision making about participation in cancer clinical trials: development of a question prompt list

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Slow accrual to cancer clinical trials impedes the progress of effective new cancer treatments. Poor physician–patient communication has been identified as a key contributor to low trial accrual. Question prompt lists (QPLs) have demonstrated a significant promise in facilitating communication in general, surgical, and palliative oncology settings. These simple patient interventions have not been tested in the oncology clinical trial setting. We aimed to develop a targeted QPL for clinical trials (QPL-CT).

Method

Lung, breast, and prostate cancer patients who either had (trial experienced) or had not (trial naive) participated in a clinical trial were invited to join focus groups to help develop and explore the acceptability of a QPL-CT. Focus groups were audio-recorded and transcribed. A research team, including a qualitative data expert, analyzed these data to explore patients' decision-making processes and views about the utility of the QPL-CT prompt to aid in trial decision making.

Results

Decision making was influenced by the outcome of patients' comparative assessment of perceived risks versus benefits of a trial, and the level of trust patients had in their doctors' recommendation about the trial. Severity of a patient's disease influenced trial decision making only for trial-naive patients.

Conclusion

Although patients were likely to prefer a paternalistic decision-making style, they expressed valuation of the QPL as an aid to decision making. QPL-CT utility extended beyond the actual consultation to include roles both before and after the clinical trial discussion.

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Acknowledgments

This project was funded by the United States National Cancer Institute RO3 Small Grants Award—CA130598.

Conflict of interest

No authors have a financial relationship with the project sponsors. The authors have primary control of the data that are available for review on request.

Author information

Authors and Affiliations

  1. Department of Social and Behavioral Health, Virginia Commonwealth University School of Medicine, 1112 East Clay St, Richmond, VA, 23298-0149, USA

    Richard F. Brown

  2. Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, 10022, USA

    Elyse Shuk, Jamie Ostroff & Shawna Edgerson

  3. Ontario Cancer Institute, Princess Margaret Hospital, 610 University Ave, Toronto, ON, M5G 2M9, Canada

    Natasha Leighl

  4. Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney, Brennan/McCallum Building (A18), Sydney, NSW, 2006, Australia

    Phyllis Butow & Martin Tattersall

  5. Department of Cancer Medicine, School of Medicine, University of Sydney, Blackburn Building, Sydney, NSW, 2006, Australia

    Martin Tattersall

Authors
  1. Richard F. Brown
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  2. Elyse Shuk
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  3. Natasha Leighl
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  4. Phyllis Butow
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  5. Jamie Ostroff
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  6. Shawna Edgerson
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  7. Martin Tattersall
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Corresponding author

Correspondence to Richard F. Brown.

Appendix 1 Question prompt list

Appendix 1 Question prompt list

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Brown, R.F., Shuk, E., Leighl, N. et al. Enhancing decision making about participation in cancer clinical trials: development of a question prompt list. Support Care Cancer 19, 1227–1238 (2011). https://doi.org/10.1007/s00520-010-0942-6

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  • DOI: https://doi.org/10.1007/s00520-010-0942-6

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