Grant: Project Grant

Many people experience chemotherapy-induced peripheral neuropathy (CIPN) during taxane-based treatment for breast cancer. Since there are no ways to prevent it and very few ways to treat it, taxane dose reduction and/or premature discontinuation are the main methods used to manage it. Yet, these treatment changes could impact cancer treatment effectiveness and survival. By the time they must be considered, CIPN reversibility is unknown. Unfortunately, guidelines about when to consider treatment changes are unclear. We do not know how decisions are made and what support is needed. This study aims to investigate patient and healthcare practitioner (HCP: oncologist, nurse, pharmacist) decision-making in CIPN-related treatment changes. Specifically, we will: 1) Describe how patients, caregivers, and HCP make CIPN-related treatment change decisions; 2) Determine patient, caregiver, and HCP CIPN-related DR/PD decision needs. This qualitative study will include people with breast cancer who develop CIPN symptoms, their caregivers, and their HCP. We will record clinical encounters between patients, caregivers, and HCP where CIPN and CIPN-related treatment changes are discussed, conduct one-on-one interviews after a decision to change treatment because of CIPN, and perform document analysis of chart notes documenting CIPN. Information gained from this study will be used to refine a patient-centric decision framework to better reflect patient, caregiver, and HCP roles in decision-making, guide future research to improve clinical decision pathways and clarify existing clinical practice guidelines about when and for whom treatment changes should be considered to manage CIPN. It will also be used in a future study to develop and test needs-based supports to help patients, caregivers, and HCP work together to make high-quality, evidence- and values-based decisions about CIPN-related chemotherapy treatment changes.