PMID- 31454424 OWN - NLM STAT- MEDLINE DCOM- 20200526 LR - 20231020 IS - 1097-0142 (Electronic) IS - 0008-543X (Print) IS - 0008-543X (Linking) VI - 125 IP - 24 DP - 2019 Dec 15 TI - Stakeholder perspectives on addressing adverse events from adjuvant cancer therapy: A qualitative study. PG - 4471-4480 LID - 10.1002/cncr.32448 [doi] AB - BACKGROUND: With increasing survival rates, a growing population of patients with cancer have received or will receive adjuvant therapy to prevent cancer recurrences. Patients and caregivers will confront the complexities of balancing the preventative benefits of adjuvant therapy with possible near-term or long-term adverse events (AEs). Adjuvant treatment-related AEs (from minimal to severe) can impact therapeutic adherence, quality of life, emotional and physical health, and survival. However, to the authors' knowledge, limited information is available regarding how stakeholders use or desire to use adjuvant-related AE information to inform the care of patients with cancer. METHODS: A qualitative, purposeful sampling approach was used to elicit stakeholder feedback via semistructured interviews (24 interviews). Drug development, drug regulatory, clinical, payer, and patient/patient advocacy stakeholders were questioned about the generation, dissemination, and use of adjuvant treatment-related AE information to inform the care of patients with cancer. Transcripts were coded independently by 2 senior health care researchers and reconciled to identify key themes. RESULTS: All stakeholder groups in the current study identified needed improvements in each of the following 4 areas: 1) improving the accessibility and relevance of AE-related information; 2) better integrating and implementing available information regarding AEs for decisions; 3) connecting contemporary cultural and economic value systems to the generation and use of information regarding adjuvant treatment-related AEs; and 4) addressing a lack of alignment and ownership of stakeholder efforts to improve the use of AE information in the adjuvant setting. CONCLUSIONS: Despite commonalities in the overall needs identified by the diverse stakeholders in the current study, broad systemic change has been stymied. The current study identified the lack of alignment and the absence of a central "owner" of these diffuse efforts as a previously unrecognized hurdle to realizing the desired systemic improvements. Future initiatives aimed at improving quality of life and outcomes for patients receiving adjuvant therapy through the improved use of AE information must address this challenge through innovative collectives and novel leadership strategies. CI - (c) 2019 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. FAU - Pettit, Syril D AU - Pettit SD AUID- ORCID: 0000-0002-4320-5343 AD - Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina. AD - Health and Environmental Sciences Institute, Washington, DC. FAU - Silberman, Pamela AU - Silberman P AD - Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina. FAU - Hassmiller Lich, Kristen AU - Hassmiller Lich K AD - Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina. FAU - Kirch, Rebecca A AU - Kirch RA AD - National Patient Advocate Foundation, Washington, DC. FAU - Lipshultz, Steven E AU - Lipshultz SE AD - Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York. FAU - Teal, Randall AU - Teal R AD - Connected Health for Applications & Interventions (CHAI) Core, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. FAU - Basch, Ethan AU - Basch E AD - Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina. AD - Cancer Outcomes Research Program, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. LA - eng PT - Journal Article DEP - 20190827 PL - United States TA - Cancer JT - Cancer JID - 0374236 SB - IM MH - Caregivers MH - Chemotherapy, Adjuvant/*adverse effects/methods MH - Health Care Surveys MH - Health Personnel MH - Humans MH - Neoplasms/*epidemiology/therapy MH - Physicians MH - Qualitative Research PMC - PMC6916390 OTO - NOTNLM OT - adjuvant OT - adverse effects OT - adverse events (AEs) OT - quality of life OT - survivorship COIS- Syril D. Pettit's employer, the nonprofit Health and Environmental Sciences Institute, receives some of its charitable donations from sectors referenced in this research, including pharmaceutical companies as well as government agencies such as the US Food and Drug Administration. The work described in the current study was conducted in Dr. Pettit's capacity as a doctoral student at the University of North Carolina Gillings School of Public Health and was not directed or funded by the Health and Environmental Sciences Institute. No funding was received or provided for the research in this study and no conflicts are reported. Steven E. Lipshultz has received National Cancer Institute grant 1R01 CA211996-01; has received National Institutes of Health grants HL072705, HL078522, HL053392, CA127642, CA068484, HD052104, AI50274, HD052102, HL087708, HL079233, HL004537, HL087000, HL007188, HL094100, HL095127, and HD80002; has received grants from Pfizer, the Michael Garig Fund, the Women's Cancer Association, and Sofia's Hope Inc; has acted as a paid consultant for Clinigen; has acted as a paid member of the Data Safety Monitoring Board for Axio Research; and has received honoraria from Biomed Central for work performed outside of the current study. Ethan Basch has received grants from the National Cancer Institute and the Patient-Centered Outcomes Research Institute; has acted as a paid expert consultant on research projects for Memorial Sloan Kettering Cancer Center, the Dana-Farber Cancer Institute, the Centers for Medicare and Medicaid Services, and RTI International (formerly Research Triangle Institute); and has acted as a paid scientific advisor for Noona Healthcare, Sivan Healthcare, and Self Care Catalysts. The other authors made no disclosures. EDAT- 2019/08/28 06:00 MHDA- 2020/05/27 06:00 PMCR- 2019/12/17 CRDT- 2019/08/28 06:00 PHST- 2019/04/09 00:00 [received] PHST- 2019/07/03 00:00 [revised] PHST- 2019/07/19 00:00 [accepted] PHST- 2019/08/28 06:00 [pubmed] PHST- 2020/05/27 06:00 [medline] PHST- 2019/08/28 06:00 [entrez] PHST- 2019/12/17 00:00 [pmc-release] AID - CNCR32448 [pii] AID - 10.1002/cncr.32448 [doi] PST - ppublish SO - Cancer. 2019 Dec 15;125(24):4471-4480. doi: 10.1002/cncr.32448. Epub 2019 Aug 27.