Perceived benefits and risks of participation in a clinical trial for Ugandan children with sickle cell anemia.

Abstract:

INTRODUCTION:Understanding factors that affect the decisions of caregivers of African children to enroll their children in clinical trials would lead to more fully informed consent. METHODS:During the NOHARM study (NCT01976416), a placebo-controlled clinical trial of hydroxyurea for Ugandan children with sickle cell anemia (SCA), 206 caregivers were given a semistructured questionnaire about factors that influenced participation in the study and their perceptions of study benefits and risks. Factors were further assessed with focus group discussions. RESULTS:Caregivers identified education provided during the recruitment process (44%), the child's current poor state of health (35%), and the possibility of improvement in the child's health (16%) as their primary initial reasons for deciding to participate in the NOHARM trial. Concerns regarding the drug or participation in a research study, including the stated concern of death by several caregivers, were outweighed by the possibility of improvement in the child's health. During the study, 72% of caregivers cited improved health as an advantage of study participation, while disadvantages cited included the potential side effects of hydroxyurea, most of which did not occur during the trial. DISCUSSION:Our study findings highlight the generally poor state of health of Ugandan children with SCA, the desperation by caregivers for anything that could improve the child's health, and the inevitable improvements in care that result from strict adherence to a study protocol, even a protocol based on local guidelines. Studies in this vulnerable population must be careful not to portray improved care as a primary incentive for participation.

journal_name

Pediatr Blood Cancer

journal_title

Pediatric blood & cancer

authors

Carman AS,Sautter C,Anyanwu JN,Ssemata AS,Opoka RO,Ware RE,Rujumba J,John CC

doi

10.1002/pbc.27830

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

e27830

issue

2

eissn

1545-5009

issn

1545-5017

journal_volume

67

pub_type

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