University of Hawaii Cancer Center, Honolulu, HI.
Current Affiliation: University of Vermont Cancer Center, Burlington, VT.
JCO Oncol Pract. 2022 Jul;18(7):e1114-e1121. doi: 10.1200/OP.21.00655. Epub 2022 Mar 16.
Although effective care coordination (CC) is recognized as a vital component of a patient-centered, high-quality cancer care delivery system, CC experiences of patients who enroll and receive treatment through clinical trials (CTs) are relatively unknown. Using mixed methods, we examined perceptions of CC among patients enrolled onto therapeutic CTs through the Hawaii Minority/Underserved National Cancer Institute Community Oncology Research Program.
The Care Coordination Instrument, a validated instrument, was used to measure patients' perceptions of CC among CT participants (n = 45) and matched controls (n = 45). Paired -tests were used to compare overall and three CC domain scores (Communication, Navigation, and Operational) between the groups. Semistructured focus group interviews were conducted virtually with 14 CT participants in 2020/2021.
CT participants reported significantly higher total CC scores than non-CT participants ( = .0008). Similar trends were found for Navigation and Operational domain scores ( = .007 and .001, respectively). Twenty-nine percent of CT participants reported receiving high-intensity CC assistance from their clinical research professionals (CRPs). Content analysis of focus group discussions revealed that nearly half of the focus group discussions centered on CRPs (47%), including CC support provided by CRPs (26%). Other key themes included general CT experiences (22%) and CRP involvement as an additional benefit to CT participation (15%).
Our results show that patients on CTs in this study had a more positive CC experience. This may be attributable in part to CC support provided by CRPs. These findings highlight both the improved experience of treatment for patients participating in a trial and the generally unrecognized yet integral role of CRPs as part of a cancer CT care team.
尽管有效的医患协调（CC）被认为是患者为中心、高质量癌症护理提供系统的重要组成部分，但参与临床试验（CT）并接受治疗的患者的 CC 体验相对未知。本研究采用混合方法，通过夏威夷少数民族/服务不足国家癌症研究所社区肿瘤学研究计划，调查了在治疗性 CT 中入组的患者对 CC 的看法。
采用经过验证的医患协调工具（Care Coordination Instrument），测量 CT 参与者（n=45）和匹配对照组（n=45）的 CC 感知。采用配对检验比较两组的总体和三个 CC 领域评分（沟通、导航和操作）。2020/2021 年，对 14 名 CT 参与者进行了虚拟的半结构式焦点小组访谈。
CT 参与者报告的 CC 总分明显高于非 CT 参与者（=0.0008）。导航和操作领域的评分也存在类似的趋势（=0.007 和 0.001）。29%的 CT 参与者报告其临床研究专业人员（CRPs）提供高强度 CC 协助。焦点小组讨论的内容分析显示，近一半的焦点小组讨论集中在 CRPs（47%），包括 CRPs 提供的 CC 支持（26%）。其他关键主题包括一般 CT 经验（22%）和 CRP 参与作为 CT 参与的额外好处（15%）。
我们的研究结果表明，本研究中 CT 组患者的 CC 体验更积极。这可能部分归因于 CRPs 提供的 CC 支持。这些发现突出了参与试验的患者治疗体验的改善，以及 CRPs 作为癌症 CT 护理团队不可或缺的一部分的普遍未被认识到的重要作用。
