Deciding to enrol in a cancer trial: a systematic review of qualitative studies

Viljoen, Bianca ORCID: and Chambers, Suzanne and Dunn, Jeff and Ralph, Nicholas ORCID: and March, Sonja ORCID: (2020) Deciding to enrol in a cancer trial: a systematic review of qualitative studies. Journal of Multidisciplinary Healthcare, 13. pp. 1257-1281.

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Viljoen et al. (2020). Deciding to Enrol in A Cancer Trial. Published Review.pdf
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Background: Clinical trials are essential for the advancement of cancer treatments; however, participation by patients is suboptimal. Currently, there is a lack of synthesized qualitative review evidence on the patient experience of trial entry from which to further develop decision support. The aim of this review is to synthesise literature reporting experiences of participants when deciding to enrol in a cancer clinical trial in order to inform practice.

Methods: A systematic review and meta-synthesis of qualitative studies were conducted to describe the experiences of adult cancer patients who decided to enrol in a clinical trial of an anti-cancer treatment.

Results: Forty studies met eligibility criteria for inclusion. Three themes were identified representing the overarching domains of experience when deciding to enrol in a cancer trial: 1) need for trial information; (2) trepidation towards participation; and (3) justifying the decision. The process of deciding to enrol in a clinical trial is one marked by uncertainty, emotional distress and driven by the search for a cure.

Conclusion: Findings from this review show that decision support modelled by shared decision-making and the quality of a shared decision needs to be accompanied by tailored or personalised psychosocial and supportive care. Although the decision process bears similarities to theoretical processes outlined in decision-making frameworks, there are a lack of supportive interventions for cancer patients that are adapted to the clinical trial context. Theory-based interventions are urgently required to support the specific needs of patients deciding whether to participate in cancer trials.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: © 2020 Viljoen et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Nursing and Midwifery (1 Jan 2015 -)
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Date Deposited: 29 Jan 2021 06:24
Last Modified: 31 Jan 2021 22:54
Uncontrolled Keywords: advanced cancer, qualitative, guideline development, consolidated framework for implementation research
Fields of Research (2008): 11 Medical and Health Sciences > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified
17 Psychology and Cognitive Sciences > 1702 Cognitive Sciences > 170202 Decision Making
Fields of Research (2020): 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520302 Clinical psychology
42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified
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