‘Once I knew there was a choice, I wanted to exercise that choice': using qualitative methods to understand why patients decline surgical trials.

Harrop, Emily ORCID: https://orcid.org/0000-0003-2820-0023, Kelly, John, Neal, David, Dasgupta, Prokar, Basnett, Gillian, Huddart, Robert, Barham, Allan, Thompson, Colin, Casbard, Angela ORCID: https://orcid.org/0000-0001-6241-3052, Jundi, Hala, Griffiths, Gareth and Nelson, Annmarie ORCID: https://orcid.org/0000-0002-6075-8425 2013. ‘Once I knew there was a choice, I wanted to exercise that choice': using qualitative methods to understand why patients decline surgical trials. Trials 14 (S1) , P9 (2013). 10.1186/1745-6215-14-s1-p9

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Abstract

The BOLERO trial (Bladder cancer: Open versus Lapararoscopic or RObotic cystectomy) is a pilot study to determine the feasibility of randomisation to open versus laparoscopic access cystectomy in patients with bladder cancer. We describe the results of an embedded qualitative sub-study which explored why patients decline randomisation. Methods: 10 semi structured interviews were undertaken with patients recruited from 3 sites in England. Data were analysed for key themes. Results: Most patients declined the trial because they had preferences for, and could choose, which surgical method they would be given- in most cases the robotic option. Patients described an intuitive ‘sense' that favoured the new technology and had carried out their own inquiries, including internet research and talking with previous patients and with friends and family with medical backgrounds. Medical histories and lifestyle considerations also shaped these personalised choices. Of importance too, however, were the messages patients perceived from their clinical encounters. Whilst some patients felt their surgeon favoured the robotic option, others interpreted ‘indirect' cues such as the ‘established' reputation of the surgeon and surgical method and comments made during pre-op assessments. Many patients expressed a wish for greater direction from their surgeon when making these decisions. Conclusion: Patients like to exercise informed choice over the type of surgery they receive. For trials where the ‘new technology' is routinely available to patients, there will likely be difficulties with recruitment. This questions the feasibility of similar trials in the future.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Publisher:	BioMed Central
ISSN:	1745-6215
Date of First Compliant Deposit:	5 August 2022
Last Modified:	14 Jun 2023 17:33
URI:	https://orca.cardiff.ac.uk/id/eprint/150339

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