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Slade AL, Retzer A, Ahmed K, Kyte D, Keeley T, Armes J, Brown JM, Calman L, Gavin A, Glaser AW, Greenfield DM, Lanceley A, Taylor RM, Velikova G, Turner G, Calvert MJ. Systematic review of the use of translated patient-reported outcome measures in cancer trials. Trials 2021; 22:306. [PMID: 33902699 PMCID: PMC8074490 DOI: 10.1186/s13063-021-05255-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 04/08/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) are used in clinical trials to assess the effectiveness and tolerability of interventions. Inclusion of participants from different ethnic backgrounds is essential for generalisability of cancer trial results. PRO data collection should include appropriately translated patient-reported outcome measures (PROMs) to minimise missing data and sample attrition. METHODS Protocols and/or publications from cancer clinical trials using a PRO endpoint and registered on the National Institute for Health Research Portfolio were systematically reviewed for information on recruitment, inclusion of ethnicity data, and use of appropriately translated PROMs. Semi-structured interviews were conducted with key stakeholders to explore barriers and facilitators for optimal PRO trial design, diverse recruitment and reporting, and use of appropriately translated PROMs. RESULTS Eighty-four trials met the inclusion criteria, only 14 (17%) (n = 4754) reported ethnic group data, and ethnic group recruitment was low, 611 (13%). Although 8 (57%) studies were multi-centred and multi-national, none reported using translated PROMs, although available for 7 (88%) of the studies. Interviews with 44 international stakeholders identified a number of perceived barriers to ethnically diverse recruitment including diverse participant engagement, relevance of ethnicity to research question, prominence of PROs, and need to minimise investigator burden. Stakeholders had differing opinions on the use of translated PROMs, the impact of trial designs, and recruitment strategies on diverse recruitment. Facilitators of inclusive research were described and examples of good practice identified. CONCLUSIONS Greater transparency is required when PROs are used as primary or secondary outcomes in clinical trials. Protocols and publications should demonstrate that recruitment was accessible to diverse populations and facilitated by trial design, recruitment strategies, and appropriate PROM usage. The use of translated PROMs should be made explicit when used in cancer clinical trials.
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Affiliation(s)
- A L Slade
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. .,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK. .,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, West Midlands, UK.
| | - A Retzer
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - K Ahmed
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - D Kyte
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.,National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK
| | - T Keeley
- Patient Centred Outcomes, GlaxoSmithKline, Brentford, UK
| | - J Armes
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,School of Health Sciences, University of Surrey, Guildford, UK.,NIHR Applied Research Collaboration Kent Surrey & Sussex University of Surrey, Guildford, UK
| | - J M Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - L Calman
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Macmillan Survivorship Research Group, Health Sciences, University of Southampton, Highfield Campus, Southampton, UK
| | - A Gavin
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Northern Ireland Cancer Registry, Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - A W Glaser
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - D M Greenfield
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - A Lanceley
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - R M Taylor
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - G Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - G Turner
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - M J Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, West Midlands, UK.,National Institute for Health Research Applied Research Collaboration, University of Birmingham, Birmingham, West Midlands, UK.,Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, West Midlands, UK
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Sodergren SC, Wheelwright SJ, Permyakova NV, Patel M, Calman L, Smith PWF, Din A, Richardson A, Fenlon D, Winter J, Corner J, Foster C. Supportive care needs of patients following treatment for colorectal cancer: risk factors for unmet needs and the association between unmet needs and health-related quality of life-results from the ColoREctal Wellbeing (CREW) study. J Cancer Surviv 2019; 13:899-909. [PMID: 31512164 PMCID: PMC6881415 DOI: 10.1007/s11764-019-00805-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/30/2019] [Indexed: 12/20/2022]
Abstract
Purpose To investigate unmet needs of patients with colorectal cancer (CRC) at the end of treatment and whether unmet needs improve over time. Identify predictors of need following treatment and whether unmet need is associated with worse health-related quality of life (HRQoL). Methods As part of the UK ColoREctal Wellbeing (CREW) cohort study, patients treated for CRC completed the Supportive Care Needs Survey Short Form-34 (SCNS SF-34) 15 and 24 months following surgery, along with questionnaires measuring HRQoL, wellbeing, life events, social support, and confidence to manage their cancer before surgery, 3, 9, 15, and 24 months post-surgery. Results The SCNS SF-34 was completed by 526 patients at 15 months and 510 patients at 24 months. About one-quarter of patients had at least one moderate or severe unmet need at both time points. Psychological and physical unmet needs were the most common and did not improve over time. Over 60% of patients who reported 5 or more moderate or severe unmet needs at 15 months experienced the same level of unmet need at 24 months. HRQoL at the beginning of treatment predicted unmet needs at the end of treatment. Unmet needs, specifically physical, psychological, and health system and information needs, were associated with poorer health and HRQoL at the end of treatment. Conclusions Unmet needs persist over time and are associated with HRQoL. Evaluation of HRQoL at the start of treatment would help inform the identification of vulnerable patients. Assessment and care planning in response to unmet needs should be integrated into person-centred care. Implications for Cancer Survivors Early identification of CRC patients at risk of unmet needs will help infrom personalised survivorship care plans. The implementation of personalised and tailored services are likely to confer HRQoL gains. Electronic supplementary material The online version of this article (10.1007/s11764-019-00805-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S C Sodergren
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, S017 1BJ, UK
| | - S J Wheelwright
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, S017 1BJ, UK
| | - N V Permyakova
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, S017 1BJ, UK
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, UK
| | - M Patel
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, S017 1BJ, UK
| | - L Calman
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, S017 1BJ, UK
| | - P W F Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, UK
| | - A Din
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, S017 1BJ, UK
| | - A Richardson
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D Fenlon
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - J Winter
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, S017 1BJ, UK
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J Corner
- Executive Office, University of Nottingham, Nottingham, UK
| | - C Foster
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, S017 1BJ, UK.
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Foster C, Breckons M, Cotterell P, Barbosa D, Calman L, Corner J, Fenlon D, Foster R, Grimmett C, Richardson A, Smith PW. Cancer survivors' self-efficacy to self-manage in the year following primary treatment. J Cancer Surviv 2015; 9:11-9. [PMID: 25028218 PMCID: PMC4341005 DOI: 10.1007/s11764-014-0384-0] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 07/01/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE Cancer survivors are increasingly expected to manage the consequences of cancer and its treatment for themselves. There is evidence that self-efficacy is important for successful self-management and that this can be enhanced with support. The purpose of this study was to assess self-efficacy to manage problems in the year following primary treatment. METHODS This cross-sectional online survey included cancer survivors who had completed their treatment within the past 12 months. Self-efficacy was assessed and variables expected to be associated with self-efficacy were measured using validated scales including quality of life, well-being, illness perceptions, depression and social support. RESULTS One hundred eighty-two respondents (mean age 50; 81% female) completed the survey. They had been treated for a range of cancers; most commonly breast (45%). Self-efficacy scores varied between individuals and according to the illness-related task to be managed. Respondents were least confident in managing fatigue and most confident in accessing information about their cancer. Individuals most likely to report low self-efficacy were women, those experiencing higher levels of pain and/or depression, lower well-being scores, lower socio-economic status, low levels of social support, or a more negative perception of cancer. CONCLUSIONS Self-efficacy to self-manage problems faced as a consequence of cancer and its treatment can vary widely in the year following treatment. Fatigue may be particularly difficult to manage. IMPLICATIONS FOR CANCER SURVIVORS Variations in self-efficacy highlight the importance of assessing specific problems faced and people's confidence to manage them in order to tailor appropriate self-management support.
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Affiliation(s)
- C Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK,
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Foster C, Calman L, Grimmett C, Breckons M, Cotterell P, Yardley L, Joseph J, Hughes S, Jones R, Leonidou C, Armes J, Batehup L, Corner J, Fenlon D, Lennan E, Morris C, Neylon A, Ream E, Turner L, Richardson A. Managing fatigue after cancer treatment: development of RESTORE, a web-based resource to support self-management. Psychooncology 2015; 24:940-9. [DOI: 10.1002/pon.3747] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 12/03/2014] [Accepted: 12/16/2014] [Indexed: 11/10/2022]
Affiliation(s)
- C. Foster
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - L. Calman
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - C. Grimmett
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - M. Breckons
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - P. Cotterell
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - L. Yardley
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - J. Joseph
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - S. Hughes
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - R. Jones
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - C. Leonidou
- School of Psychology; University of Southampton; Southampton SO17 1BJ UK
| | - J. Armes
- Florence Nightingale School of Nursing and Midwifery; Kings College London; London SW1 8WA UK
| | - L. Batehup
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - J. Corner
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - D. Fenlon
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - E. Lennan
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - C. Morris
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - A. Neylon
- Macmillan Cancer Support; London SE1 7UQ UK
| | - E. Ream
- School of Health Sciences; University of Surrey; Guildford GU2 7TE UK
| | - L. Turner
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
| | - A. Richardson
- Faculty of Health Sciences; University of Southampton; Southampton SO17 1BJ UK
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