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Cancer patients’ perceptions of factors influencing their decisions on participation in clinical drug trials: A qualitative meta‐synthesis

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  • Zandra Engelbak Nielsen
  • Connie Bøttcher Berthelsen

Abstract

Aims and objectives To examine cancer patients’ perceptions of factors that may influence their decisions on participating in phase I–III clinical drug trials. Background The number of cancer participants in clinical drug trials has increased rapidly in Denmark in recent years. The rights, safety and well‐being of patients considering participation are protected by the international, ethical and scientific principles. A meta‐synthesis was conducted to enable health professionals to support cancer patients who are considering trial participation in accordance with the above principles. Design Meta‐synthesis. Methods A qualitative meta‐synthesis, as described by Sandelowski and Barroso, was conducted based on a literature search in PubMed, CINAHL, EMBASE and PsycINFO. Nine reports were found eligible and were included. The PRISMA checklist was used. Results A framework was developed, and patients’ perceptions of the factors influencing their decisions were identified, namely patients’ perceptions of their relatives, the physician, the hope of therapeutic benefit, altruism, having other options and living with cancer. Conclusions This study shows that cancer patients’ decisions on participation in clinical drug trials are influenced by their perceptions of trust towards the physician, their relatives’ attitudes and the consequences participation might have for their families. Patients are motivated to participate due to the hope of therapeutic benefit and for altruistic reasons. The factors influencing their decisions to participate include a cost‐benefit consideration, which in turn may be subject to the patient's perception of having other options available besides participation. This may be related to the patient's attitude towards living with cancer, and the decision can be a way of trying to cope with the psychological aspects of living with cancer. Relevance to clinical practice The results of this meta‐synthesis offer insight into patients’ perceptions of what may influence their decisions, and they enable health professionals to support patients making such decisions.

Suggested Citation

  • Zandra Engelbak Nielsen & Connie Bøttcher Berthelsen, 2019. "Cancer patients’ perceptions of factors influencing their decisions on participation in clinical drug trials: A qualitative meta‐synthesis," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(13-14), pages 2443-2461, July.
    • Handle: RePEc:wly:jocnur:v:28:y:2019:i:13-14:p:2443-2461
    DOI: 10.1111/jocn.14785
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    References listed on IDEAS

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    1. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    2. Margaret M. Byrne & Stacey L. Tannenbaum & Stefan Glück & Judith Hurley & Michael Antoni, 2014. "Participation in Cancer Clinical Trials," Medical Decision Making, , vol. 34(1), pages 116-126, January.
    3. Gaston, Christine M. & Mitchell, Geoffrey, 2005. "Information giving and decision-making in patients with advanced cancer: A systematic review," Social Science & Medicine, Elsevier, vol. 61(10), pages 2252-2264, November.
    4. George, S. & Duran, N. & Norris, K., 2014. "A systematic review of barriers and facilitators to minority research participation among African Americans, Latinos, Asian Americans, and Pacific Islanders," American Journal of Public Health, American Public Health Association, vol. 104(2), pages 16-31.
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