Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2022; 14(6): 1175-1186
Published online Jun 15, 2022. doi: 10.4251/wjgo.v14.i6.1175
Characterizing the patient experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma: A qualitative study
Lena Stevens, Zachary J Brown, Ryan Zeh, Christina Monsour, Sharla Wells-Di Gregorio, Heena Santry, Aslam M Ejaz, Timothy Michael Pawlik, Jordan M Cloyd
Lena Stevens, Zachary J Brown, Christina Monsour, Heena Santry, Aslam M Ejaz, Timothy Michael Pawlik, Jordan M Cloyd, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Ryan Zeh, Department of General Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
Sharla Wells-Di Gregorio, Department of Psychiatry, Center for Palliative Care, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Author contributions: Cloyd JM designed the research study; Stevens L, Zeh R, Monsour C and Cloyd JM performed the research; Stevens L, Brown ZJ and Cloyd JM analyzed the data and wrote the manuscript; Wells-Di Gregorio S, Santry H, Ejaz AM and Pawlik TM provided expert opinion and edits to the manuscript; and All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of The Ohio State University.
Informed consent statement: All study participants provided informed verbal consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jordan M Cloyd, MD, Assistant Professor, Doctor, Department of Surgery, The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210, United States. jordan.cloyd@osumc.edu
Received: January 14, 2022
Peer-review started: January 14, 2022
First decision: March 13, 2022
Revised: April 1, 2022
Accepted: May 17, 2022
Article in press: May 17, 2022
Published online: June 15, 2022
ARTICLE HIGHLIGHTS
Research background

Neoadjuvant therapy (NT) has increasingly been utilized for patients with localized pancreatic ductal adenocarcinoma (PDAC). It is the recommended approach for borderline resectable (BR) and locally advanced (LA) and it has also increasingly been utilized for potentially resectable (PR) disease. However, little research has focused on patient-centered metrics among patients undergoing NT, including patient experiences, preferences, and recommendations.

Research motivation

A better understanding of all aspects of the patient experience during NT may help identify opportunities to design interventions aimed at improving quality of life. It may also facilitate the completion of NT and receipt of surgery, ultimately optimizing long-term outcomes.

Research objectives

This research aims to understand the experience of patients initiating and receiving NT to identify opportunities to improve neoadjuvant cancer care delivery.

Research methods

Semi-structured, open-ended interviews of patients with localized PDAC during NT were conducted to explore their experience initiating and receiving NT. Interviews were conducted over the phone. All interviews were audio recorded, transcribed, and coded by two independent researchers using NVivo 12, iteratively identifying themes until thematic saturation was achieved.

Research results

A total of 12 patients with localized PDAC were interviewed. All patients indicated that choosing NT was the doctor’s recommendation and most reported not being familiar with the concept of NT (n = 11, 92%). Five patient experience themes emerged: physical symptoms, emotional symptoms, coping mechanisms, access to care, and life factors. Improved education before and during NT was the most commonly cited recommendation for improving the experience during NT (n = 7, 58%). Patients highlighted the need for more information on the rationale behind choosing NT prior to surgery, the anticipated surgery and its likelihood of surgery occurring after NT, as well as general information prior to starting NT treatment.

Research conclusions

This study provides a framework to allow for a better understanding of the PDAC patient experience during NT and highlights opportunities to improve quality and quantity of life outcomes.

Research perspectives

This exploratory research utilizes qualitative interviews to examine the patient experience when initiating and receiving NT.