Author(s): Sherratt F.C.; Young B.; Jenkinson M.D.; Haylock B.J.; Javadpour M.
Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 3); p. 314
Publication Date: 2018
Publication Type(s): Conference Abstract
Abstract:Objectives: ROAM is a randomised controlled trial comparing radiation to observation following complete surgical resection of atypical meningioma. We embedded a qualitative sub-study within ROAM with the aim of optimising patient recruitment. Design: Qualitative sub-study. Subjects: Patients invited to participate in ROAM and recruiting clinicians. Methods: Audio-recorded recruitment consultation (N = 20), and semi-structured interviews with clinicians (N = 8) and patients (N = 18), including decliners and consenters. Analysis of transcribed audio-recordings was informed by content and thematic analysis. Results: Analysis has identified areas where communication was problematic. Giving patients their pathology results immediately before discussing ROAM left them overwhelmed and unable to absorb trial information. Clinicians’ presentation of the trial arms often lacked balance. Several patients viewed the prospect of radiotherapy as illogical, in part, due to earlier conversations with surgeons that indicated further treatment was unnecessary following resection. Patients who declined ROAM were concerned about the side effects of radiotherapy and viewed it as burdensome; many struggled to interpret key details of ROAM due to problematic communication. Conclusions: Embedded qualitative studies can address barriers to recruitment in neurosurgical trials. We have amended the patient information leaflet and provided workshops for surgeons and oncologists to enhance communication about ROAM, with the aim of optimising patient recruitment.