Improvingpatient understanding of GEPtestresults (IMPARTER4): an RCT

Fallowfield, Lesley; Solis-Trapala, Ivonne; Starkings, Rachel; Matthews, Lucy; May, Shirley; Jenkins, Valerie

Abstract

Objective Explaining gene expression profiling (GEP) test results to patients can be challenging. We examined the utility of two 8 min films about Oncotype DX and Prosigna to aid the knowledge and decision-making of women with early-stage oestrogen receptor positive (ER+) breast cancer.

Methods and analysis Patients awaiting GEP test results completed an anxiety questionnaire and the intolerance of uncertainty scale (IUS) before randomisation and divided into Group A (standard verbal and/or written hospital information) or Group B (standard information plus GEP film). Prior to results, they were interviewed about their GEP test knowledge and how the recurrence risk helps determine treatment options. After the results consultation, participants answered two further questionnaires. Participating clinicians completed IUS scales and reported their satisfaction with the results discussions.

Results 230/251 patients completed the study (Group A (n=106) and Group B (n=124)). The total knowledge score was higher in Group B (estimated between groups mean difference of 2.5 (95% CI:1.7 to 3.4) p<0.001). Most treatment decisions adhered to recommended risk of recurrence thresholds, although patients with higher trait anxiety were more likely to make less apparently rational decisions OR=0.93 (95%CI 0.88 to 0.97) p=0.002 (163/230; 70.8% received ET alone; 65/230; 28% ET plus chemotherapy, and two sought second opinions). Clinicians reported slightly longer consultations for Group A participants who tended to ask more difficult and unexpected questions.

Conclusion Patients who received standard verbal and written information plus film had increased knowledge about GEP tests compared with standard information alone.

Citation

Fallowfield, L., Solis-Trapala, I., Starkings, R., Matthews, L., May, S., & Jenkins, V. (2025). Improvingpatient understanding of GEPtestresults (IMPARTER4): an RCT. BMJ Oncology, https://doi.org/10.1136/bmjonc-2024-000689

• Journal Article Type: Article
• Acceptance Date: Feb 7, 2025
• Online Publication Date: Mar 21, 2025
• Publication Date: 2025-03
• Deposit Date: Mar 31, 2025
• Journal: BMJ Oncology
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1136/bmjonc-2024-000689
• Public URL: https://keele-repository.worktribe.com/output/1112787
• Publisher URL: https://bmjoncology.bmj.com/