Influence of Clinical Communication on Patients' Decision Making on Participation in Clinical Trials
- 1 June 2008
- journal article
- clinical trial
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 26 (16), 2666-2673
- https://doi.org/10.1200/jco.2007.14.8114
Abstract
Purpose: To investigate how communication among physicians, patients, and family/companions influences patients' decision making about participation in clinical trials. Patients and Methods: We video recorded 235 outpatient interactions occurring among oncologists, patients, and family/companions (if present) at two comprehensive cancer centers. We combined interaction analysis of the real-time video-recorded observations (collected at Time 1) with patient self-reports (Time 2) to determine how communication about trial offers influenced accrual decisions. Results: Clinical trials were explicitly offered in 20% of the interactions. When offers were made and patients perceived they were offered a trial, 75% of patients assented. Observed messages (at Time 1) directly related to patients' self-reports regarding their decisions (2 weeks later), and how they felt about their decisions and their physicians. Specifically, messages that help build a sense of an alliance (among all parties, including the family/companions), provide support (tangible assistance and reassurance about managing adverse effects), and provide medical content in language that patients and family/companions understand are associated with the patient's decision and decision-making process. Conclusion: In two urban, National Cancer Institute–designated comprehensive cancer centers, a large percentage of patients are not offered trials. When offered a trial, most patients enroll. The quality and quantity of communication occurring among the oncologist, patient, and family/companion when trials are discussed matter in the patient's decision-making process. These findings can help increase physician awareness of the ways that messages and communication behaviors can be observed and evaluated to improve clinical practice and research.Keywords
This publication has 37 references indexed in Scilit:
- Oncologists’ recommendations of clinical trial participation to patientsPatient Education and Counseling, 2008
- Processes to Activate Phase III Clinical Trials in a Cooperative Oncology Group: The Elephant Is MonstrousJournal of Clinical Oncology, 2007
- Provider roles in the recruitment of underrepresented populations to cancer clinical trialsCancer, 2007
- Information seeking during “bad news” oncology interactions: Question asking by patients and their companionsSocial Science & Medicine, 2006
- Invisible Barriers to Clinical Trials: The Impact of Structural, Infrastructural, and Procedural Barriers to Opening Oncology Clinical TrialsJournal of Clinical Oncology, 2006
- Predictors of enrollment in lung cancer clinical trialsCancer, 2005
- Participation in the RACS Sentinel Node Biopsy versus Axillary Clearance TrialAnz Journal of Surgery, 2005
- Why Cancer Patients Enter Randomized Clinical Trials: Exploring the Factors That Influence Their DecisionJournal of Clinical Oncology, 2004
- An assessment of age and other factors influencing protocol versus alternative treatments for patients with epithelial ovarian cancer referred to member institutions: a Gynecologic Oncology Group studyGynecologic Oncology, 2004
- Managing Accrual in Cooperative Group Clinical TrialsJournal of Clinical Oncology, 2004