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Cancer patients’ and clinicians’ opinions on the best time in secondary care to approach patients for recruitment to longitudinal questionnaire-based research

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Abstract

Purpose

A priority of the UK National Cancer Survivorship Initiative is to increase collection of patient-reported outcome measures (PROMs) longitudinally post-diagnosis. This study aimed to gather cancer patients’ and clinicians’ opinions and preferences about the best time, in the secondary care pathway, to approach patients about joining longitudinal observational PROMs-based (LO-PROMs) research.

Methods

The sample comprised 15 patients with non-metastatic breast, colorectal or prostate cancer, and 15 clinicians including surgeons, oncologists and nurse specialists. Patients and clinicians participated in one face-to-face topic-guided audio-recorded interview. Data were analysed using thematic content analysis.

Results

Patients did not want to be approached about LO-PROMs research early in the care pathway, near diagnosis and treatment planning or before any surgery and its results. Patients felt that LO-PROMs research is best introduced from the time people are ‘settled’ on (post-surgical) treatment regimens, provided they are coping well emotionally and not experiencing significant physical side effects; patients emphasised variability in people’s experience of and response to cancer and treatment. Clinicians also advised against approach near diagnosis, although generally recommended initiating recruitment somewhat sooner than patients.

Conclusions

Patients expressed strong homogeneous preferences and ideally wanted to be approached about LO-PROMs research when their initial fears and anxiety about cancer treatment and survival had diminished, and they felt some sense of certainty and optimism about the future. As the timeline of clinical events varies, maximising recruitment may mean approaching patients at varied time points post-diagnosis. Further recruitment implications are discussed.

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References

  1. Maddams J, Brewster D, Gavin A, Steward J, Elliott J, Utley M, Møller H (2009) Cancer prevalence in the United Kingdom: estimates for 2008. Br J Cancer 101:541–547

    Article  PubMed  CAS  Google Scholar 

  2. Harrison SE, Watson EK, Ward AM et al (2011) Primary health and supportive care needs of long-term cancer survivors: a questionnaire survey. J Clin Oncol 29:2091–2098

    Article  PubMed  Google Scholar 

  3. Elliott J, Fallows A, Staetsky L, Smith PWF, Foster CL, Maher EJ, Corner J (2011) The health and well-being of cancer survivors in the UK: findings from a population-based survey. Br J Cancer 105:S11–S20

    Article  PubMed  Google Scholar 

  4. Richardson A, Addington-Hall J, Amir Z et al (2011) Knowledge, ignorance and priorities for research in key areas of cancer survivorship: findings from a scoping review. Br J Cancer 105:S82–S94

    Article  PubMed  Google Scholar 

  5. Lerro CC, Stein KD, Smith T, Virgo KS (2012) A systematic review of large-scale surveys of cancer survivors conducted in North America, 2000–2011. J Cancer Surviv 6(2):115–145

    Article  PubMed  Google Scholar 

  6. Foster C, Wright D, Hill H, Hopkinson J, Roffe L (2009) Psychosocial implications of living 5 years or more following a cancer diagnosis: a systematic review of the research evidence. Eur J Cancer Care 18:223–247

    Article  CAS  Google Scholar 

  7. National Cancer Survivorship Initiative Vision document. Available at http://www.ncsi.org.uk/wp-content/uploads/NCSI-Vision-Document.pdf. Accessed 28 November 2011

  8. Lipscomb J, Gotay CC, Snyder CF (2007) Patient-reported outcomes in cancer: a review of recent research and policy initiatives. CA Cancer J Clin 57:278–300

    Article  PubMed  Google Scholar 

  9. Easterbrook PJ, Matthews DR (1992) Fate of research studies. J R Soc Med 85:71–76

    PubMed  CAS  Google Scholar 

  10. Dilts DM, Sandler AB (2006) Invisible barriers to clinical trials: the impact of structural, infrastructural, and procedural barriers to opening oncology clinical trials. J Clin Oncol 24:4545–4552

    Article  PubMed  Google Scholar 

  11. Chaplin JM, Morton RP (1999) A prospective, longitudinal study of pain in head and neck cancer patients. Head Neck 21:531–537

    Article  PubMed  CAS  Google Scholar 

  12. Jansen L, Herrmann A, Stegmaier C, Singer S, Brenner H, Arndt V (2011) Health-related quality of life during the 10 years after diagnosis of colorectal cancer: a population-based study. J Clin Oncol 29:3263–3269

    Article  PubMed  Google Scholar 

  13. Kwan ML, Ambrosone CB, Lee MM et al (2008) The pathways study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California. Cancer Causes Control 19:1065–1076

    Article  PubMed  Google Scholar 

  14. Potosky AL, Harlan LC, Stanford JL et al (1999) Prostate cancer practice patterns and quality of life: the Prostate Cancer Outcomes study. J Natl Cancer Inst 91:1719–1724

    Article  PubMed  CAS  Google Scholar 

  15. Smith T, Stein KD, Mehta CC et al (2007) The rationale, design, and implementation of the American Cancer Society’s Studies of Cancer Survivors. Cancer 109:1–12

    Article  PubMed  Google Scholar 

  16. Hepworth J, Robertson AR, Jhunjhunwala A, Jarvis GC, McVittie C (2011) Cancer-related psychosocial research: what are the perspectives of cancer care centre users on participation? Support Care Cancer 19:1029–1035

    Article  PubMed  Google Scholar 

  17. Ashley L, Jones H, Thomas J et al (2011) Integrating cancer survivors' experiences into UK cancer registries: design and development of the ePOCS system (electronic Patient-reported Outcomes from Cancer Survivors). Br J Cancer 105:S74–S81

    Article  PubMed  Google Scholar 

  18. Hetherton J, Matheson A, Robson M (2004) Recruitment by GPs during consultations in a primary care randomized controlled trial comparing computerized psychological therapy with clinical psychology and routine GP care: problems and possible solutions. Prim Health Care Res Dev 5:5–10

    Article  Google Scholar 

  19. Hummers-Pradier E, Scheidt-Nave C, Martin H, Heinemann S, Kochen M, Himmel W (2008) Simply no time? Barriers to GPs' participation in primary health care research. Fam Pract 25:105–112

    Article  PubMed  Google Scholar 

  20. Ashley L, Jones H, Forman D et al (2011) Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: the electronic patient-reported outcomes from cancer survivors (ePOCS) system. BMC Med Inform Decis Mak 11:66

    Article  PubMed  Google Scholar 

  21. Stewart DW, Shamdasani PN, Rook DW (2007) Focus groups: theory and practice, 2nd edn. Sage, London

    Google Scholar 

  22. Krueger RA (1994) Focus groups: a practical guide for applied research, 2nd edn. Sage, London

    Google Scholar 

  23. Orom H, Penner LA, West BT, Downs TM, Rayford W, Underwood W (2009) Personality predicts prostate cancer treatment decision-making difficulty and satisfaction. Psycho-Oncol 18:290–299

    Article  Google Scholar 

  24. Birnie K, Robinson J (2010) Helping patients with localized prostate cancer reach treatment decisions. Can Fam Physician 56:137–141

    PubMed  Google Scholar 

  25. Ford S, Fallowfield L, Lewis S (1994) Can oncologists detect distress in their out-patients and how satisfied are they with their performance during bad news consultations? Br J Cancer 70:767–770

    Article  PubMed  CAS  Google Scholar 

  26. Laugsand EA, Sprangers MAG, Bjordal K, Skorpen F, Kaasa S, Klepstad P (2010) Health care providers underestimate symptom intensities of cancer patients: a multicenter European study. Health Qual Life Outcomes 8:104

    Article  PubMed  Google Scholar 

  27. Wright EP, Kiely MA, Lynch P, Cull A, Selby PJ (2002) Social problems in oncology. Br J Cancer 87:1099–1104

    Article  PubMed  CAS  Google Scholar 

  28. Nicolson P, Kopp Z, Chapple CR, Kelleher C (2008) It's just the worry about not being able to control it! A qualitative study of living with overactive bladder. Br J Health Psychol 13:343–359

    Article  PubMed  Google Scholar 

  29. Travaglia JF, Nugus PI, Greenfield D, Westbrook JI, Braithwaite J (in press) Visualising differences in professionals' perspectives on quality and safety. BMJ Qual Saf

  30. Shipman C, Hotopf M, Richardson A et al (2008) The views of patients with advanced cancer regarding participation in serial questionnaire studies. Palliat Med 22:913–920

    Article  PubMed  CAS  Google Scholar 

  31. Ziebland S, Featherstone K, Snowdon C, Barker K, Frost H, Fairbank J (2007) Does it matter if clinicians recruiting for a trial don't understand what the trial is really about? Qualitative study of surgeons' experiences of participation in a pragmatic multi-centre RCT. Trials 8:4

    Article  PubMed  Google Scholar 

  32. Lubeck DP, Litwin MS, Henning JM, Carroll PR (1997) Measurement of health-related quality of life in men with prostate cancer: the CaPSURE database. Qual Life Res 6:385–392

    Article  PubMed  CAS  Google Scholar 

  33. Phillips K-A, Osborne RH, Giles GG, Dite GS, Apicella C, Hopper JL, Milne RL (2008) Psychosocial factors and survival of young women with breast cancer: a population-based prospective cohort study. J Clin Oncol 26:4666–4671

    Article  PubMed  Google Scholar 

  34. Jenkins V, Farewell D, Batt L et al (2010) The attitudes of 1066 patients with cancer towards participation in randomised clinical trials. Br J Cancer 103:1801–1807

    Article  PubMed  CAS  Google Scholar 

  35. Mills EJ, Seely D, Rachlis B et al (2006) Barriers to participation in clinical trials of cancer: a meta-analysis and systematic review of patient-reported factors. Lancet Oncol 7:141–148

    Article  PubMed  Google Scholar 

  36. Fenton L, Rigney M, Herbst RS (2009) Clinical trial awareness, attitudes, and participation among patients with cancer and oncologists. Commun Oncol 6:207–228

    Article  Google Scholar 

  37. Ross S, Grant A, Counsell C, Gillespie W, Russell I, Prescott R (1999) Barriers to participation in randomised controlled trials: a systematic review. J Clin Epidemiol 52:1143–1156

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

We thank the patients and clinicians who gave their time to participate in this study and the Robert Ogden Macmillan Centre for providing interview rooms. This study was funded by Macmillan Cancer Support, with additional financial support from Cancer Research UK, and sponsored by the University of Leeds. We also acknowledge the support of the National Institute for Health Research, through the National Cancer Research Network.

Competing interests

The authors declare that they have no competing interests.

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Correspondence to Laura Ashley.

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Ashley, L., Jones, H., Velikova, G. et al. Cancer patients’ and clinicians’ opinions on the best time in secondary care to approach patients for recruitment to longitudinal questionnaire-based research. Support Care Cancer 20, 3365–3372 (2012). https://doi.org/10.1007/s00520-012-1518-4

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  • DOI: https://doi.org/10.1007/s00520-012-1518-4

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