Patients' Information Needs for Informed Consent to Participate in First-in-Human Pig Kidney Xenotransplant Clinical Trials: A Mixed Methods Study.

IF 3.3 4区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Elisa J Gordon, Michael K Gusmano, Jessica Gacki-Smith, Hannah L Brooks, Margaret M Matthews, Dahlya Manning, Joseph Leventhal, Karen J Maschke
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引用次数: 0

Abstract

Background: Transplant programs preparing to initiate first-in-human pig kidney xenotransplant clinical trials must be especially careful when obtaining participants' informed consent. Little is known about the kind of information patients want for making an informed decision about trial participation.

Methods: We conducted semi-structured telephone interviews with waitlisted kidney transplant patients about information needs regarding participating in a first-in-human pig kidney xenotransplant trial, which guided development of a prototype consent form. Subsequent usability testing interviews sought patient feedback on the consent form. We analyzed qualitative data by thematic analysis and quantitative data by descriptive statistics.

Results: Twenty-eight patients participated in semi-structured interviews; 16 patients participated in usability testing interviews. Most interview participants were male (68%, 56%), White (54%, 56%), or Black (36%, 31%), respectively. Interview participants identified five types of information needs: (1) the potential for infection contraction and transmission; (2) risks, benefits, and impact of xenotransplant trials; (3) xenotransplant clinical trial and recipient experience; (4) clinical trial logistics; and (5) the pig and its kidney. Usability testing participants suggested adding details to the prototype. Participants' preparedness to make a decision about participating in a xenotransplant trial increased after reviewing the prototype (12.5% vs. 31.3%, n.s.).

Conclusion: We identified multiple unique types of information patients desired to make informed decisions about pig kidney xenotransplant trial participation. Transplant programs initiating xenotransplant trials should be prepared to address patients' information needs to optimize informed decision-making for trial participation. The prototype consent form may support a patient-centered approach to informed consent.

患者知情同意参与首次人类猪肾异种移植临床试验的信息需求:一项混合方法研究
背景:准备开展首次人类猪肾异种移植临床试验的移植项目在获得参与者的知情同意时必须特别小心。对于患者需要什么样的信息来做出参与试验的知情决定,人们知之甚少。方法:我们对等待肾移植的患者进行了半结构化的电话访谈,了解参与首次人类猪肾异种移植试验的信息需求,这指导了同意书原型的开发。随后的可用性测试访谈寻求患者对同意书的反馈。定性数据采用专题分析,定量数据采用描述性统计。结果:28例患者参加了半结构化访谈;16名患者参加了可用性测试访谈。大多数受访者分别是男性(68%,56%)、白人(54%,56%)和黑人(36%,31%)。受访者确定了五种类型的信息需求:(1)感染、收缩和传播的可能性;(2)异种移植试验的风险、益处和影响;(3)异种移植临床试验和受者经验;(4)临床试验后勤;(5)猪和它的肾。可用性测试参与者建议在原型中添加细节。在审查原型后,参与者决定参加异种移植试验的准备程度增加了(12.5%对31.3%,n.s.)。结论:我们确定了多种独特类型的信息,患者希望做出明智的决定是否参加猪肾异种移植试验。启动异种移植试验的移植项目应准备好满足患者的信息需求,以优化参与试验的知情决策。同意书原型可以支持以患者为中心的知情同意方法。
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来源期刊
Xenotransplantation
Xenotransplantation 医学-医学:研究与实验
CiteScore
6.80
自引率
15.40%
发文量
58
审稿时长
>12 weeks
期刊介绍: Xenotransplantation provides its readership with rapid communication of new findings in the field of organ and tissue transplantation across species barriers.The journal is not only of interest to those whose primary area is xenotransplantation, but also to veterinarians, microbiologists and geneticists. It also investigates and reports on the controversial theological, ethical, legal and psychological implications of xenotransplantation.
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