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采用定性退出访谈法探究临床试验患者的精神分裂症负担及治疗体验。

Using qualitative exit interviews to explore schizophrenia burden and treatment experience in clinical trial patients.

作者信息

Simmons Adam, O'Sullivan Amy K, Carpenter-Conlin Julia, Carty Michelle K, Saucier Cory, McDonnell David

机构信息

Alkermes, Inc., Waltham, MA, United States.

QualityMetric, LLC, Johnston, RI, United States.

出版信息

Front Psychiatry. 2024 Aug 21;15:1377174. doi: 10.3389/fpsyt.2024.1377174. eCollection 2024.

Abstract

INTRODUCTION

Qualitative research methods can be used to obtain a deeper understanding of patient experience by collecting information in the patients' own words about their encounters, perspectives, and feelings. In this study, patients with schizophrenia were interviewed to capture their voice and to complement the quantitative data typically obtained in clinical trials.

METHODS

Semi-structured exit interviews were conducted with 41 patients who completed or prematurely discontinued from a phase 3, open-label trial (NCT02873208). The interview guide included open-ended questions on current and prior disease burden, symptoms, quality of life, and treatment experiences. Steps taken to reduce interview stress and secure the validity of data included interviewer sensitivity training specific to mental health conditions and schizophrenia, use of in-person interviews whenever possible and use of videoconferencing for remote interviews to promote trust and comfort, and working closely with clinical site staff to identify patient eligibility and willingness to participate. Transcripts based on audio recordings were content coded and analyzed using thematic analysis; a quantitative content analysis was conducted.

RESULTS

Patients reported that the symptoms of schizophrenia negatively impacted their work, relationships, self-esteem, emotional health, and daily activities. Most patients had positive experiences with medications that alleviated hallucinations, depression, and anxiety. However, side effects of medications were associated with negative impacts on physical, emotional, behavioral, and cognitive health. Lack of energy/drowsiness, weight gain, mood changes, and involuntary movements were the most common side effects reported with the use of antipsychotic medications. Patients reported unmet treatment needs related to better symptom control and to improved social and physical functioning.

CONCLUSION

Collection of qualitative information within a schizophrenia clinical development process provides value and insights into patients' views on burden of illness, experiences with previous medications, and experiences following participation in a clinical trial and can inform design for future studies.

摘要

引言

定性研究方法可用于通过用患者自己的语言收集有关其遭遇、观点和感受的信息,来更深入地了解患者体验。在本研究中,对精神分裂症患者进行访谈以获取他们的心声,并补充临床试验中通常获得的定量数据。

方法

对41名完成或提前退出一项3期开放标签试验(NCT02873208)的患者进行了半结构化出院访谈。访谈指南包括关于当前和既往疾病负担、症状、生活质量和治疗经历的开放式问题。为减轻访谈压力并确保数据有效性所采取的步骤包括针对心理健康状况和精神分裂症的访谈者敏感性培训,尽可能采用面对面访谈,并使用视频会议进行远程访谈以促进信任和舒适感,以及与临床研究点工作人员密切合作以确定患者的资格和参与意愿。基于录音的访谈记录进行了内容编码,并使用主题分析进行了分析;还进行了定量内容分析。

结果

患者报告称,精神分裂症症状对他们的工作、人际关系、自尊、情绪健康和日常活动产生了负面影响。大多数患者在使用减轻幻觉、抑郁和焦虑的药物方面有积极体验。然而,药物副作用对身体、情绪、行为和认知健康有负面影响。缺乏精力/嗜睡、体重增加、情绪变化和不自主运动是使用抗精神病药物报告的最常见副作用。患者报告了未满足的治疗需求,涉及更好的症状控制以及改善社交和身体功能。

结论

在精神分裂症临床开发过程中收集定性信息为了解患者对疾病负担的看法、既往用药经历以及参与临床试验后的体验提供了价值和见解,并可为未来研究的设计提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bd4/11372304/116ffff27265/fpsyt-15-1377174-g001.jpg

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