Phase I cancer trials: a qualitative study of specialist palliative care

BMJ Support Palliat Care. 2020 Jun;10(2):234-241. doi: 10.1136/bmjspcare-2019-001919. Epub 2019 Nov 29.

Abstract

Objective: In recent years, a simultaneous care model for advanced cancer patients has been recommended meaning that palliative care services are offered throughout their cancer journey. To inform the successful adoption of this model in a phase I trial context, the study aimed to explore patients' care needs and their perceptions of specialist palliative care.

Methods: Semi-structured interviews were conducted with 10 advanced cancer patients referred to the Experimental Cancer Medicine team. Interviews were transcribed verbatim and thematically analysed with a framework approach to data organisation.

Results: Despite reporting considerable physical and psychological impacts from cancer and cancer treatment, participants did not recognise a need for specialist palliative care support. Understanding of the role of specialist palliative care was largely limited to end of life care. There was perceived conflict between considering a phase I trial and receiving specialist palliative care. Participants felt specialist palliative care should be introduced earlier and educational resources developed to increase patient acceptability of palliative care services.

Significance of results: Patients with advanced cancer referred for phase I trials are likely to benefit from specialist palliative care. However, this study suggests patients may not recognise a need for support nor accept this support due to misperceptions about the role of palliative care. Developing a specific educational resource about specialist palliative care for this population would help overcome barriers to engaging with a simultaneous care model.

Keywords: cancer; clinical trials; palliative care; symptoms and symptom management.

MeSH terms

  • Clinical Trials, Phase I as Topic / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Palliative Care / psychology*
  • Patient Acceptance of Health Care / psychology*
  • Qualitative Research
  • Research Subjects / psychology*
  • Terminal Care / psychology