Clinical study - Sciences Humaines et Sociales
Drug resistance is a main current challenge in oncology research, especially since most patients who die of cancer have a disseminated disease resistant to multiple treatment regimens. To communicate with patients about drug resistance is a complex task for physicians, especially as it entails further care or treatment choices, the need to foster shared medical decision-making, to talk about prognosis. Question prompt lists (QPLs) seem to efficiently facilitate communication in cancer care. As there is still no cure for patients facing with treatment resistance, the provision of a communication aid as a QPL in this context may be particularly useful. This article describes the study protocol to develop and validate such QPL.;The study procedure unfolds in two main phases. Phase 1 will develop a first draft of the QPL. First, a literature review of existing QPLs and individual interviews with health care professionals (HCPs) will aim at providing an in-depth understanding of communication issues in the cancer drug resistance clinical context. Second, the QPL content and structure will be revised and adjusted during oral and written surveys with patients, to ascertain that it responds to their communication needs. Third, focus groups with patients and HCPs will further revise and adjust the QPL and will prepare its clinical implementation. Finally, the Delphi process will validate the content of the tool. Phase 2 will be a randomized controlled trial to test the clinical utility and efficacy of the QPL among cancer patients facing drug resistance.;The QPL is meant to foster patient-centered communication processes, and therefore more caring patient-physician relationships when discussing drug resistance. It should thereby enable better patient self-management, while managing their expectations, and uncertainty.