Patient acceptability of three different central venous access devices for the delivery of systemic anticancer therapy

a qualitative study

Caoimhe Ryan (Lead / Corresponding author), Hannah Hesselgreaves, Olivia Wu, Jonathan Moss, James Paul, Judith Dixon-Hughes, Evi Germeni

Research output: Contribution to journalArticle

Abstract

Objective: Three types of central venous access devices (CVADs) are routinely used in the delivery of intravenous systemic anticancer therapy (SACT): peripherally inserted central catheters (PICCs), subcutaneously tunnelled central catheters (Hickman-type devices) and totally implantable chest wall ports (Ports). This qualitative study, nested within a multicentre, randomised controlled trial, sought to explore patient acceptability and experiences of the three devices.

Design: Eight focus groups were audio-recorded, transcribed and thematically analysed.

Setting: Six outpatient cancer treatment centres in the UK.

Participants: Forty-two patients (20 female, mean age 61.7 years) who had taken part or were taking part in the broader trial.

Intervention: As part of the larger, randomised controlled trial, participants had been randomly assigned one of three CVADs for the administration of SACT.

Results: Attitudes towards all three devices were positive, with patients viewing their CVAD as part of their treatment and recovery. Participants with PICCs and Hickmans tended to compare their device favourably with peripheral cannulation. By comparison, participants with Ports consistently compared their device with PICCs and Hickmans, emphasising the perceived superiority of Ports. Ports were perceived to offer unique psychological benefits, including a greater sense of freedom and less intrusion in the context of personal relationships.

Conclusions: Patient experiences and preferences have not been systematically used to inform policy and practice regarding CVAD availability and selection. Our research identified patterns of patient device preferences that favoured Ports, although this was not universal. Results of this study could improve support for patients and offer greater scope for incorporating patient perspectives into decision-making processes.

Trial Registration Number: ISRCTN44504648.

Original languageEnglish
Article numbere026077
Pages (from-to)1-9
Number of pages9
JournalBMJ Open
Volume9
Issue number7
DOIs
Publication statusPublished - 9 Jul 2019

Fingerprint

Equipment and Supplies
Catheters
Therapeutics
Patient Preference
Randomized Controlled Trials
Thoracic Wall
Focus Groups
Catheterization
Decision Making
Outpatients
Psychology
Research
Neoplasms

Keywords

  • chemotherapy
  • interventional radiology
  • oncology
  • qualitative research

Cite this

Ryan, Caoimhe ; Hesselgreaves, Hannah ; Wu, Olivia ; Moss, Jonathan ; Paul, James ; Dixon-Hughes, Judith ; Germeni, Evi. / Patient acceptability of three different central venous access devices for the delivery of systemic anticancer therapy : a qualitative study. In: BMJ Open. 2019 ; Vol. 9, No. 7. pp. 1-9.
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abstract = "Objective: Three types of central venous access devices (CVADs) are routinely used in the delivery of intravenous systemic anticancer therapy (SACT): peripherally inserted central catheters (PICCs), subcutaneously tunnelled central catheters (Hickman-type devices) and totally implantable chest wall ports (Ports). This qualitative study, nested within a multicentre, randomised controlled trial, sought to explore patient acceptability and experiences of the three devices.Design: Eight focus groups were audio-recorded, transcribed and thematically analysed.Setting: Six outpatient cancer treatment centres in the UK.Participants: Forty-two patients (20 female, mean age 61.7 years) who had taken part or were taking part in the broader trial.Intervention: As part of the larger, randomised controlled trial, participants had been randomly assigned one of three CVADs for the administration of SACT.Results: Attitudes towards all three devices were positive, with patients viewing their CVAD as part of their treatment and recovery. Participants with PICCs and Hickmans tended to compare their device favourably with peripheral cannulation. By comparison, participants with Ports consistently compared their device with PICCs and Hickmans, emphasising the perceived superiority of Ports. Ports were perceived to offer unique psychological benefits, including a greater sense of freedom and less intrusion in the context of personal relationships.Conclusions: Patient experiences and preferences have not been systematically used to inform policy and practice regarding CVAD availability and selection. Our research identified patterns of patient device preferences that favoured Ports, although this was not universal. Results of this study could improve support for patients and offer greater scope for incorporating patient perspectives into decision-making processes.Trial Registration Number: ISRCTN44504648.",
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Patient acceptability of three different central venous access devices for the delivery of systemic anticancer therapy : a qualitative study. / Ryan, Caoimhe (Lead / Corresponding author); Hesselgreaves, Hannah; Wu, Olivia; Moss, Jonathan; Paul, James; Dixon-Hughes, Judith; Germeni, Evi.

In: BMJ Open, Vol. 9, No. 7, e026077, 09.07.2019, p. 1-9.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Patient acceptability of three different central venous access devices for the delivery of systemic anticancer therapy

T2 - a qualitative study

AU - Ryan, Caoimhe

AU - Hesselgreaves, Hannah

AU - Wu, Olivia

AU - Moss, Jonathan

AU - Paul, James

AU - Dixon-Hughes, Judith

AU - Germeni, Evi

N1 - This study was funded by the National Institute for Health Research (NIHR) Health Technology Assessment (11/67/01).

PY - 2019/7/9

Y1 - 2019/7/9

N2 - Objective: Three types of central venous access devices (CVADs) are routinely used in the delivery of intravenous systemic anticancer therapy (SACT): peripherally inserted central catheters (PICCs), subcutaneously tunnelled central catheters (Hickman-type devices) and totally implantable chest wall ports (Ports). This qualitative study, nested within a multicentre, randomised controlled trial, sought to explore patient acceptability and experiences of the three devices.Design: Eight focus groups were audio-recorded, transcribed and thematically analysed.Setting: Six outpatient cancer treatment centres in the UK.Participants: Forty-two patients (20 female, mean age 61.7 years) who had taken part or were taking part in the broader trial.Intervention: As part of the larger, randomised controlled trial, participants had been randomly assigned one of three CVADs for the administration of SACT.Results: Attitudes towards all three devices were positive, with patients viewing their CVAD as part of their treatment and recovery. Participants with PICCs and Hickmans tended to compare their device favourably with peripheral cannulation. By comparison, participants with Ports consistently compared their device with PICCs and Hickmans, emphasising the perceived superiority of Ports. Ports were perceived to offer unique psychological benefits, including a greater sense of freedom and less intrusion in the context of personal relationships.Conclusions: Patient experiences and preferences have not been systematically used to inform policy and practice regarding CVAD availability and selection. Our research identified patterns of patient device preferences that favoured Ports, although this was not universal. Results of this study could improve support for patients and offer greater scope for incorporating patient perspectives into decision-making processes.Trial Registration Number: ISRCTN44504648.

AB - Objective: Three types of central venous access devices (CVADs) are routinely used in the delivery of intravenous systemic anticancer therapy (SACT): peripherally inserted central catheters (PICCs), subcutaneously tunnelled central catheters (Hickman-type devices) and totally implantable chest wall ports (Ports). This qualitative study, nested within a multicentre, randomised controlled trial, sought to explore patient acceptability and experiences of the three devices.Design: Eight focus groups were audio-recorded, transcribed and thematically analysed.Setting: Six outpatient cancer treatment centres in the UK.Participants: Forty-two patients (20 female, mean age 61.7 years) who had taken part or were taking part in the broader trial.Intervention: As part of the larger, randomised controlled trial, participants had been randomly assigned one of three CVADs for the administration of SACT.Results: Attitudes towards all three devices were positive, with patients viewing their CVAD as part of their treatment and recovery. Participants with PICCs and Hickmans tended to compare their device favourably with peripheral cannulation. By comparison, participants with Ports consistently compared their device with PICCs and Hickmans, emphasising the perceived superiority of Ports. Ports were perceived to offer unique psychological benefits, including a greater sense of freedom and less intrusion in the context of personal relationships.Conclusions: Patient experiences and preferences have not been systematically used to inform policy and practice regarding CVAD availability and selection. Our research identified patterns of patient device preferences that favoured Ports, although this was not universal. Results of this study could improve support for patients and offer greater scope for incorporating patient perspectives into decision-making processes.Trial Registration Number: ISRCTN44504648.

KW - chemotherapy

KW - interventional radiology

KW - oncology

KW - qualitative research

UR - http://www.scopus.com/inward/record.url?scp=85068867910&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2018-026077

DO - 10.1136/bmjopen-2018-026077

M3 - Article

VL - 9

SP - 1

EP - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 7

M1 - e026077

ER -