Cancer Education Center, Mayo Clinic Cancer Center, Rochester, MN, USA.
J Cachexia Sarcopenia Muscle. 2014 Jun;5(2):121-5. doi: 10.1007/s13539-014-0128-z. Epub 2014 Mar 13.
Fewer than 5 % of cancer patients participate in clinical research. Although this paltry rate has led to extensive research on this topic, previous studies have not sought verbatim comments in a real-time, comprehensive manner to understand why patients decline.
This study used a low-risk, non-interventional parent study that focused on cancer-associated weight loss to understand patients' reasons for declining research participation. A research assistant wrote down the name and verbatim reason of all patients who declined to participate. These comments with accompanying patient demographic data are the subject of this report.
Of the 334 patients, 51 (15 %) declined parent study enrollment; three comment-related themes emerged: (1) a repelling sense of too much institutional research, (2) overwhelming personal health issues, and (3) a low likelihood of returning to the institution. In univariate and multivariate analyses, only age (older) and gender (female) were associated with non-enrollment. Interestingly, 41 patients with fatigue scores of 7 or worse and 26 with pain scores of 7 or worse were enrolled.
Although many factors were associated with declining to participate in research, symptom severity was not. Upfront education might help cancer patients better prioritize their participation in research, particularly as some patients felt overwhelmed by too much research in the institution; and for now, investigators should continue to keep asking patients for their participation.
参与临床研究的癌症患者不足 5%。尽管这一低比例导致了对此问题的广泛研究,但之前的研究并未以实时、全面的方式寻求逐字评论,以了解患者拒绝的原因。
本研究使用了一项低风险、非干预性的母研究,该研究专注于癌症相关体重减轻,以了解患者拒绝参与研究的原因。一名研究助理记下了所有拒绝参与的患者的姓名和逐字原因。这些评论以及伴随的患者人口统计学数据是本报告的主题。
在 334 名患者中,有 51 名(15%)拒绝了母研究的入组;三个评论相关主题出现:(1)对过多机构研究的排斥感,(2)个人健康问题的压倒性,(3)返回机构的可能性低。在单变量和多变量分析中,仅年龄(较大)和性别(女性)与未入组相关。有趣的是,41 名疲劳评分 7 或更高的患者和 26 名疼痛评分 7 或更高的患者被入组。
尽管许多因素与拒绝参与研究有关,但症状严重程度并非如此。预先教育可能有助于癌症患者更好地优先考虑参与研究,特别是因为一些患者感到机构内的研究过多而不堪重负;目前,研究人员应继续征求患者的参与意愿。