Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.
School of Nursing, Columbia University, New York, NY, USA; Ann May Center for Nursing, Hackensack Meridian Health, Neptune, NJ, USA.
J Cyst Fibros. 2018 Nov;17(6):736-741. doi: 10.1016/j.jcf.2018.01.011. Epub 2018 Mar 14.
Recruiting both pediatric and adult participants for clinical trials in CF is currently of paramount importance as numerous new therapies are being developed. However, recruitment is challenging as parents of children with CF and adults with CF cite safety concerns as a principal barrier to enrollment. In conjunction with the CF Foundation (CFF) Data Safety Monitoring Board (DSMB), a pilot brochure was developed to inform patients and parents of the multiple levels of safety monitoring; the CFF simultaneously created an infographic representing the safety monitoring process. This study explores the attitudes and beliefs of CF patients and families regarding safety monitoring and clinical trial participation, and elicits feedback regarding the educational materials.
Semi-structured interviews were conducted using a pre-tested interview guide and audio-recorded during routine CF clinic visits. Participants included 5 parents of children with CF <16years old; 5 adolescents and young adults with CF 16-21years old; and 5 adults with CF ≥22years old from pediatric and adult CF centers. The study team performed systematic text condensation analysis of the recorded interviews using an iterative process.
Four major thematic categories with subthemes emerged as supported by exemplar quotations: attitudes toward clinical trials, safety values, conceptualizing the safety monitoring process, and priorities for delivery of patient education. Participant feedback was used to revise the pilot brochure; text was shortened, unfamiliar words clarified (e.g., "pipeline"), abbreviations eliminated, and redundancy avoided.
Qualitative analysis of CF patient and family interviews provided insights into barriers to participation in clinical trials, safety concerns, perspectives on safety monitoring and educational priorities. We plan a multicenter study to determine if the revised brochure reduces knowledge, attitude and practice barriers regarding participation in CF clinical trials.
由于正在开发许多新疗法,目前招募儿科和成年参与者进行临床试验至关重要。然而,由于囊性纤维化(CF)患儿的父母和成年 CF 患者将安全性问题作为参与的主要障碍,招募工作具有挑战性。与囊性纤维化基金会(CFF)数据安全监测委员会(DSMB)合作,制定了试点小册子,向患者和家长告知多个级别的安全监测;CFF 同时创建了一个信息图,代表安全监测过程。本研究探讨了 CF 患者及其家属对安全监测和临床试验参与的态度和信念,并就教育材料征求了反馈意见。
使用经过预先测试的访谈指南在常规 CF 诊所就诊期间进行半结构化访谈,并进行音频记录。参与者包括 5 名年龄小于 16 岁的 CF 患儿的父母;5 名年龄在 16-21 岁的 CF 青少年和年轻人;以及 5 名来自儿科和成人 CF 中心的年龄在 22 岁及以上的 CF 成年患者。研究小组使用迭代过程对记录的访谈进行系统的文本浓缩分析。
通过示例引文支持,出现了四个主要主题类别和子主题:对临床试验的态度、安全价值观、对安全监测过程的概念化以及患者教育的优先事项。参与者的反馈用于修改试点小册子;缩短了文本,澄清了不熟悉的单词(例如,“pipeline”),删除了缩写,并避免了冗余。
对 CF 患者和家属访谈的定性分析提供了对临床试验参与的障碍、安全性问题、对安全监测和教育重点的看法的深入了解。我们计划进行一项多中心研究,以确定修订后的小册子是否可以减少参与 CF 临床试验的知识、态度和实践障碍。