Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, 450 Brookline Ave LW518, Boston, MA, 02215, USA.
Present Address: University of Michigan School of Nursing, 400 North Ingalls St, Office 2350;, MI, 48109, Ann Arbor, USA.
Support Care Cancer. 2022 Dec;30(12):9963-9973. doi: 10.1007/s00520-022-07447-y. Epub 2022 Nov 10.
There are no recommended treatments for chemotherapy-induced peripheral neuropathy (CIPN) prevention. Recruitment to CIPN prevention clinical trials is challenging because it is difficult to enroll patients between the time of cancer diagnosis and the initiation of neurotoxic chemotherapy. The purpose of this exploratory-sequential mixed-methods study was to determine patients' preferences that could affect the choice to participate in CIPN prevention clinical trials.
First, twenty cognitive interviews were conducted with adults who completed less than three neurotoxic chemotherapy infusions to clarify clinical trial attributes and levels thought to be important to patients when deciding whether to enroll in CIPN prevention trials (i.e., type of treatment, clinical tests, reimbursement, survey delivery; length of visits, timing of follow-up, when to begin treatment). Second, another eighty-eight patients completed an adaptive choice-based conjoint analysis survey that incorporated the finalized attributes and levels. Each level was assigned a part-worth utility score using Hierarchical Bayes Estimation. The relative importance of each attribute was calculated.
The attributes with the highest relative importance values were type of treatment (27.1%) and length of study visits (20.2%). The preferred levels included non-medicine treatment (53.49%), beginning treatment after experiencing CIPN (60.47%), email surveys (63.95%), assessments that include surveys and clinical exams (39.53%), under 30-min visits (44.19%), $50/week reimbursement (39.53%), and 1-month post-chemotherapy follow-up visits (32.56%).
Patients' preferences for participation may be included in the design of future CIPN prevention clinical trials to potentially bolster study enrollment.
目前尚无推荐的化疗引起的周围神经病(CIPN)预防治疗方法。由于难以在癌症诊断和开始使用神经毒性化疗之间招募到 CIPN 预防临床试验的患者,因此招募 CIPN 预防临床试验的患者具有挑战性。本探索性序贯混合方法研究的目的是确定可能影响患者参与 CIPN 预防临床试验选择的偏好。
首先,对完成少于 3 次神经毒性化疗输注的成年人进行了 20 次认知访谈,以阐明临床试验属性和水平,这些属性和水平被认为在决定是否参加 CIPN 预防试验时对患者很重要(即治疗类型、临床检查、报销、调查的提供;就诊次数、随访时间、何时开始治疗)。其次,另外 88 名患者完成了一项适应性基于选择的联合分析调查,其中纳入了最终确定的属性和水平。使用分层贝叶斯估计为每个水平分配部分价值效用得分。计算每个属性的相对重要性。
相对重要性值最高的属性是治疗类型(27.1%)和研究就诊次数(20.2%)。首选水平包括非药物治疗(53.49%)、在出现 CIPN 后开始治疗(60.47%)、电子邮件调查(63.95%)、包括调查和临床检查的评估(39.53%)、就诊时间少于 30 分钟(44.19%)、每周报销 50 美元(39.53%)和化疗后 1 个月随访就诊(32.56%)。
患者参与的偏好可以纳入未来 CIPN 预防临床试验的设计中,以潜在增加研究的入组率。