PURPOSE: Phase I clinical trials are the gateway to effective new cancer treatments. Many physicians have difficulty when discussing Phase I clinical trials. Research demonstrates evidence of suboptimal communication. Little is known about communication strategies used by oncologists when recruiting patients for Phase I trials. We analyzed audio recorded Phase I consultations to identify oncologists' communication strategies. PATIENTS AND METHODS: Subjects were consecutive cancer patients from six medical oncologists attending one of three outpatient clinics at a major Cancer Center in the United States. Sixteen patients signed informed consent for audio recording of their consultations in which a Phase I study was discussed. These were transcribed in full and analyzed to identify communication strategies. RESULTS: Six communication themes emerged from the analysis: (1) orienting, (2) educating patients, (3) describing uncertainty and prognosis, (4) persuading, (5) decision making, and (6) making a treatment recommendation. As expected, although there was some common ground between communication in Phase I and the Phase II and III settings, there were distinct differences. CONCLUSIONS: Oncologists used persuasive communication, made explicit recommendations, or implicitly expressed a treatment preference and were choice limiting. This highlights the complexity of discussing Phase I trials and the need to develop strategies to aid oncologists and patients in these difficult conversations. Patient centered communication that values patient preferences while preserving the oncologist's agenda can be a helpful approach to these discussions.
PURPOSE: Phase I clinical trials are the gateway to effective new cancer treatments. Many physicians have difficulty when discussing Phase I clinical trials. Research demonstrates evidence of suboptimal communication. Little is known about communication strategies used by oncologists when recruiting patients for Phase I trials. We analyzed audio recorded Phase I consultations to identify oncologists' communication strategies. PATIENTS AND METHODS: Subjects were consecutive cancerpatients from six medical oncologists attending one of three outpatient clinics at a major Cancer Center in the United States. Sixteen patients signed informed consent for audio recording of their consultations in which a Phase I study was discussed. These were transcribed in full and analyzed to identify communication strategies. RESULTS: Six communication themes emerged from the analysis: (1) orienting, (2) educating patients, (3) describing uncertainty and prognosis, (4) persuading, (5) decision making, and (6) making a treatment recommendation. As expected, although there was some common ground between communication in Phase I and the Phase II and III settings, there were distinct differences. CONCLUSIONS: Oncologists used persuasive communication, made explicit recommendations, or implicitly expressed a treatment preference and were choice limiting. This highlights the complexity of discussing Phase I trials and the need to develop strategies to aid oncologists and patients in these difficult conversations. Patient centered communication that values patient preferences while preserving the oncologist's agenda can be a helpful approach to these discussions.
Authors: Richard F Brown; Elyse Shuk; Phyllis Butow; Shawna Edgerson; Martin H N Tattersall; Jamie S Ostroff Journal: Patient Educ Couns Date: 2010-08-02
Authors: Fay J Hlubocky; Greg A Sachs; Eric R Larson; Halla S Nimeiri; David Cella; Kristen E Wroblewski; Mark J Ratain; Jeffery M Peppercorn; Christopher K Daugherty Journal: J Clin Oncol Date: 2018-07-09 Impact factor: 44.544
Authors: Fay J Hlubocky; Nancy E Kass; Debra Roter; Susan Larson; Kristen E Wroblewski; Jeremy Sugarman; Christopher K Daugherty Journal: J Oncol Pract Date: 2018-05-22 Impact factor: 3.840
Authors: Luis E Gonzalez; Steven K Sutton; Christie Pratt; Matthew Gilbertson; Scott Antonia; Gwendolyn P Quinn Journal: J Cancer Educ Date: 2013-09 Impact factor: 2.037