Patients’ and Clinicians’ Perceptions of the Clinical Utility of Predictive Risk Models for Chemotherapy-Related Symptom Management: Qualitative Exploration Using Focus Groups and Interviews (Preprint)

Abstract

BACKGROUND Interest in the application of predictive risk models (PRMs) in healthcare to identify people most likely to experience disease and treatment-related complications is increasing. In cancer care, these techniques are focused primarily on prediction of survival or life-threatening toxicities (e.g. febrile neutropenia). Fewer studies focused on use of PRMs for symptoms or supportive care needs. The application of PRMs to chemotherapy-related symptoms (CRS) would enable earlier identification and initiation of prompt, personalised and tailored interventions. While some PRMs exist for CRS, few were translated into clinical practice and human factors associated with their use were not reported. OBJECTIVE Explore patients’ and clinicians’ perspectives of the utility and real-world application of PRMs to improve the management of CRS. METHODS Focus groups (n=10) and interviews (n=5) were conducted with patients (n=28) and clinicians (n=26) across five European countries. Interactions were audio-recorded, transcribed verbatim and analysed thematically. RESULTS Both clinicians and patients recognized the value of having individualised risk predictions for CRS and appreciated how this type of information would facilitate the provision of tailored preventative treatments and/or supportive care interactions. However cautious and skeptical attitudes towards the use of PRMs in clinical care were noted by both groups particularly in relationship to the uncertainty regarding how the information would be generated. Visualisation and presentation of PRM information in a usable and useful format for both patients and clinicians was identified as a challenge to their successful implementation in clinical care. CONCLUSIONS Findings from this study provide information on clinicians’ and patients’ perspectives on the clinical use of PRMs for the management of CRS. These international perspectives are important because they provide insight into the risks and benefits of using PRMs to evaluate CRS. In addition, they highlight the need to find ways to more effectively present and use this information in clinical practice. Further research that explores the best ways to incorporate this type of information while maintaining the human side of care is warranted. CLINICALTRIAL This paper reports on a secondary objective from a larger programme of work Trial Registration: Clinical Trials.gov NCT02356081