DEprescribing: Perceptions of PAtients living with advanced cancer. A multicentre, prospective mixed observational study protocol

PLoS One. 2024 Aug 20;19(8):e0305737. doi: 10.1371/journal.pone.0305737. eCollection 2024.

Abstract

Introduction: Polypharmacy in patients with advanced cancer represents a major public health problem, leading to risk of iatrogenesis, decrease of quality of life and increase of healthcare costs. In the field of geriatrics, health policies have been developed to address polypharmacy through the use of deprescribing tools. Recently, palliative care initiatives have been introduced, yet these have not fully considered the specificities of this population, particularly their perceptions. It is therefore important to better understand patients' perceptions of deprescribing in order to adapt tools and actions to make these approaches more effective.

Objectives: The aim is to investigate patients' perceptions of deprescribing in palliative oncology care, and to explore factors that may influence patients' attitudes and beliefs about deprescribing and to validate a specific questionnaire (rPATD) in this population. An ancillary study will investigate the relationship between patients' health literacy and their perception of deprescribing.

Method: A prospective, observational, multicenter study will be conducted using a sequential mixed exploratory design in a population of patients living with advanced cancer and with a physician-estimated life expectancy of less than 1 year. The study will include an initial qualitative phase. Individual semi-structured interviews using a descriptive approach (thematic analysis) will be conducted (upon saturation). Following analysis of the qualitative data, a quantitative study including 300 patients will be realized to meet secondary objectives. Several data will be collected and 2 self-questionnaires will be administered: the BMQ (beliefs about medicine) and rPATD (perception of deprescribing) possibly supplemented by additional items if required by the qualitative analysis. The auxiliary study will be conducted during this second phase, using a validated self-questionnaire to assess patients' level of literacy.

Conclusion: The disparate outcomes will facilitate the understanding of the perception of deprescribing in palliative oncology care, enabling the development of tailored approaches adapted to this population.

Trial registration: ClinicalTrials Identifier: NCT06193083.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Deprescriptions*
  • Female
  • Humans
  • Male
  • Neoplasms* / drug therapy
  • Neoplasms* / psychology
  • Palliative Care* / methods
  • Perception
  • Polypharmacy
  • Prospective Studies
  • Quality of Life
  • Surveys and Questionnaires

Associated data

  • ClinicalTrials.gov/NCT06193083

Grants and funding

This study was funded by Fondation de France WB-2023-50257. AE received this award. Funders playes any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript https://www.fondationdefrance.org/fr/appels-a-projets/soigner-soulager-accompagner-projets-de-recherche.