Perception of the Doctor/Patient Relationship, Disease and Treatment Among Physicians and Their Patients Treated With Systemic Therapy for Hepatocellular Carcinoma “PERCEPTION1”

Overview

atients with cancer face difficult choices that require balancing competing priorities such as survival, functional capacity and symptom relief. Most patients with advanced cancer (>80%) expect their sensitive discussions with physicians about prognosis and treatment choices, in order to be involved in the decision making process. Nevertheless, this kind of discussion is frequently lacking. Consequently, patients often have a biased view of their own prognosis such as an underestimation of disease severity, or unrealistic expectations for cure. Patients with advanced hepatocellular carcinoma (HCC) may be treated with systemic therapies which may prolong survival, but are not curative. Patients with advanced HCC often report expectations for survival and treatment-related side-effects that differ from their treating physician. Accordingly, communication on prognostic and treatment choices is essential to obtain an accurate understanding of the disease that allows patients to make informed decisions. To the best of our knowledge, a thorough evaluation of the physician-patient communication quality has never been performed in advanced HCC patients. The aim of our study, is to assess the perception of the expected prognosis, the treatment side-effects; by the patient and by his investigator during the first consultation before the initiation

Full Title of Study: “Perception of the Doctor/Patient Relationship, Disease and Treatment Among Physicians and Their Patients Treated With Systemic Therapy for Hepatocellular Carcinoma”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: July 12, 2022

Detailed Description

atients with cancer face difficult choices that require balancing competing priorities such as survival, functional capacity and symptom relief. Most patients with advanced cancer (>80%) expect their sensitive discussions with physicians about prognosis and treatment choices, in order to be involved in the decision making process. Nevertheless, this kind of discussion is frequently lacking. Consequently, patients often have a biased view of their own prognosis such as an underestimation of disease severity, or unrealistic expectations for cure. Patients with advanced hepatocellular carcinoma (HCC) may be treated with systemic therapies which may prolong survival, but are not curative. Patients with advanced HCC often report expectations for survival and treatment-related side-effects that differ from their treating physician. Accordingly, communication on prognostic and treatment choices is essential to obtain an accurate understanding of the disease that allows patients to make informed decisions. To the best of our knowledge, a thorough evaluation of the physician-patient communication quality has never been performed in advanced HCC patients. The aim of our study, is to assess the perception of the expected prognosis, the treatment side-effects; by the patient and by his investigator during the first consultation before the initiation

Interventions

  • Other: Hospitalized patient with advanced hepatocellular carcinoma receiving systemic therapy.
    • Administation of two surveys to included patients, about the perception of the disease and the expectations related to the treatment. The physician will be asked to complete a survey on his or her perception of the prognosis and information received by the patient.

Clinical Trial Outcome Measures

Primary Measures

  • Evaluate the concordance between the patient’s perception of his prognosis and treatment side effects with the one of his treating physician.
    • Time Frame: 12months
    • Use of survey completed by the patient and the doctors to assess the primary endpoint

Secondary Measures

  • Compare the patient’s expectations for the aforementioned items to those of his physician and the degree of concordance between them.
    • Time Frame: 12 months
    • Use of survey completed by the patient and the doctors to assess the primary endpoint
  • Evaluation of patient satisfaction with the information received during the consultation
    • Time Frame: 12 months
    • Use of survey completed by the patient and the doctors to assess the primary endpoint
  • Assessment of patient-reported symptoms of anxiety and depression
    • Time Frame: 12 months
    • Use of survey completed by the patient and the doctors to assess the primary endpoint
  • Evaluate the association between individual prognosis expectation (patient and physician) and data from the available literature.
    • Time Frame: 12 months
    • Use of survey completed by the patient and the doctors to assess the primary endpoint

Participating in This Clinical Trial

Inclusion Criteria

1. Patient over 18 years of age 2. Patient informed and not objecting to participate in the study 3. Patient with advanced hepatocellular carcinoma. 4. Patient treated with systemic therapy Exclusion Criteria:

1. Locoregional treatment combined with systemic treatment 2. Pregnancy in progress 3. Candidate for surgery or locoregional therapy 4. Patient with state medical aid (AME)

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 90 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Assistance Publique – Hôpitaux de Paris
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Contact(s)
    • Jean-Charles NAULT, Md, PhD, 01 48 02 41 49, jean-charles.nault@aphp.fr

References

Loh KP, Mohile SG, Lund JL, Epstein R, Lei L, Culakova E, McHugh C, Wells M, Gilmore N, Mohamed MR, Kamen C, Aarne V, Conlin A, Bearden J 3rd, Onitilo A, Wittink M, Dale W, Hurria A, Duberstein P. Beliefs About Advanced Cancer Curability in Older Patients, Their Caregivers, and Oncologists. Oncologist. 2019 Jun;24(6):e292-e302. doi: 10.1634/theoncologist.2018-0890. Epub 2019 Apr 23.

Yennurajalingam S, Rodrigues LF, Shamieh O, Tricou C, Filbet M, Naing K, Ramaswamy A, Perez-Cruz PE, Bautista MJS, Bunge S, Muckaden MA, Sewram V, Fakrooden S, Noguera-Tejedor A, Rao SS, Liu D, Park M, Williams JL, Lu Z, Cantu H, Hui D, Reddy SK, Bruera E. Perception of Curability Among Advanced Cancer Patients: An International Collaborative Study. Oncologist. 2018 Apr;23(4):501-506. doi: 10.1634/theoncologist.2017-0264. Epub 2017 Nov 20.

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