期刊论文详细信息
Trials
Optimising recruitment to a late-phase tuberculosis clinical trial: a qualitative study exploring patient and practitioner experiences in Uzbekistan
Nicola James1  Emma Douch1  Beverley Stringer1  Emil Kazounis1  Nell Gray1  Alexandra Wharton-Smith1  Shona Horter1  Bern-Thomas Nyang’wa2  Jatinder Singh3  Gulayim Allanazarova3  Zinaida Tigay4  Parpieva Nargiza Nusratovna5 
[1] Manson Unit, Médecins Sans Frontières, London, UK;Manson Unit, Médecins Sans Frontières, London, UK;Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK;Public Health Department, Médecins Sans Frontières-OCA, Tashkent, Uzbekistan;Republican Phtisiology Hospital No.2, Nukus, Uzbekistan;Republican Specialised Scientific-Practical Medical Centre of Phtisiology and Pulmonology, Tashkent, Uzbekistan;
关键词: MDR-TB;    Clinical trial;    Recruitment;    Qualitative;    Community engagement;   
DOI  :  10.1186/s13063-021-05850-0
来源: Springer
PDF
【 摘 要 】

BackgroundAddressing the global burden of multidrug-resistant tuberculosis (MDR-TB) requires identification of shorter, less toxic treatment regimens. Médecins Sans Frontières (MSF) is currently conducting a phase II/III randomised controlled clinical trial, to find more effective, shorter and tolerable treatments for people with MDR-TB. Recruitment to the trial in Uzbekistan has been slower than expected; we aimed to study patient and health worker experiences of the trial, examining potential factors perceived to impede and facilitate trial recruitment, as well as general perceptions of clinical research in this context.MethodsWe conducted a qualitative study using maximum variation, purposive sampling of participants. We carried out in-depth interviews (IDIs) and focus group discussions (FGDs) guided by semi-structured topic guides. In December 2019 and January 2020, 26 interviews were conducted with patients, Ministry of Health (MoH) and MSF staff and trial health workers, to explore challenges and barriers to patient recruitment as well as perceptions of the trial and research in general. Preliminary findings from the interviews informed three subsequent focus group discussions held with patients, nurses and counsellors. Focus groups adopted a person-centred design, brainstorming potential solutions to problems and barriers. Interviews and FGDs were audio recorded, translated and transcribed verbatim. Thematic analysis, drawing on constant comparison, was used to analyse the data.ResultsHealth system contexts may compete with new approaches especially when legislative health regulations or policy around treatment is ingrained in staff beliefs, perceptions and practice, which can undermine clinical trial recruitment. Trust plays a significant role in how patients engage with the trial. Decision-making processes are dynamic and associated with relationship to diagnosis, assimilation of information, previous knowledge or experience and influence of peers and close relations.ConclusionsThis qualitative analysis highlights ways in which insights developed together with patients and healthcare workers might inform approaches towards improved recruitment into trials, with the overall objective of delivering evidence for better treatments.

【 授权许可】

CC BY   

【 预 览 】
附件列表
Files Size Format View
RO202203043921510ZK.pdf 3018KB PDF download
  文献评价指标  
  下载次数:5次 浏览次数:3次