Optimizing language for effective communication of gene therapy concepts with hemophilia patients: a qualitative study
Authors:
- Daniel P. HartDHDaniel P. Hart
- Brian R. BranchfordBBBrian R. Branchford
- Sarah HendrySHSarah Hendry
- Robert LedniczkyRLRobert Ledniczky
- Robert F. SidonioRSRobert F. Sidonio
- Claude NégrierCNClaude Négrier
- Michelle KimMKMichelle Kim
- Michelle RiceMRMichelle Rice
- Matthew MinshallMMMatthew Minshall
- Claire ArcéCAClaire Arcé
- Steve PrinceSPSteve Prince
- Maria KelleherMKMaria Kelleher
Open Access
- 28 April 2021
- journal article
- research article
- Published by Springer Nature in Orphanet Journal of Rare Diseases
- Vol. 16 (1) , 1-16
Abstract
Background: For communities of people living with hemophilia and other genetic conditions, gene therapy could represent a paradigm shift in treatment strategies. As investigational therapeutic modalities such as gene therapy become more widely used and discussed, there is a critical need for all stakeholders to communicate using a lexicon that is intelligible, accurate, consistent, and representative of novel treatments. In doing so, expectations can be more carefully managed and potential risks, benefits, and limitations better understood. In recognition of this need, a first-ever study of gene therapy lexicon was conducted using established methods of market research and linguistic analysis.Methods: Ninety-four participants representing hematologists, nurses, caregivers, and people with hemophilia A, in six countries (US, UK, Spain, Germany, France, Italy) took part in a series of in-depth interviews, face-to-face focus groups, an advisory board meeting, and online group interviews to develop, refine, and test verbal, written, and pictorial language concepts through a three-phase iterative process. Sessions were conducted in local languages using detailed discussion guides. Feedback from participants was captured using real-time instant-response dial testing to measure moment-by-moment emotional responses to language stimuli. Semiquantitative analysis of the responses informed selection of preferred language concepts for final testing, and qualitative discussion explored preference rationale. Participants also completed polling and forced rank and choice written exercises.Results: Study feedback showed that the hemophilia community has preferences around consistent lexicon to describe hemophilia and its management. Expert linguistic analysis of feedback from the three phases enabled agreement of a consensus lexicon of vocabulary and an optimized summary narrative for talking about gene therapy amongst people affected by hemophilia A. Preferences were largely consistent across audiences and countries, although some country-specific recommendations were made. A representative summary phrase was agreed: “Gene therapy is being studied in clinical trials with the aim to allow the body to produce factor VIII protein on its own”.Conclusions: The use of preferred language across different stakeholders increases understanding and comfort during discussions of novel and complex therapeutic modalities such as gene therapy. Consistent use of community-informed lexicon minimizes miscommunication and facilitates informed decision-making regarding potential future treatment opportunities.Keywords
Funding Information
- BioMarin Pharmaceutical
This publication has 32 references indexed in Scilit:
- Long-Term Safety and Efficacy of Factor IX Gene Therapy in Hemophilia BNew England Journal of Medicine, 2014
- Treatment decision‐making among Canadian youth with severe haemophilia: a qualitative approachHaemophilia, 2014
- Developing a two‐sided intervention to facilitate shared decision‐making in haemophilia: decision boxes for clinicians and patient decision aids for patientsHaemophilia, 2014
- Therapeutic levels of FVIII following a single peripheral vein administration of rAAV vector encoding a novel human factor VIII variantBlood, 2013
- Adenovirus-Associated Virus Vector–Mediated Gene Transfer in Hemophilia BNew England Journal of Medicine, 2011
- A qualitative study identifying the knowledge, attitudes and behaviours of young men with mild haemophiliaHaemophilia, 2011
- Eradication of neutralizing antibodies to factor VIII in canine hemophilia A after liver gene therapyBlood, 2010
- Emergency Department Care for Patients with Hemophilia and Von Willebrand DiseaseThe Journal of Emergency Medicine, 2010
- Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groupsInternational Journal for Quality in Health Care, 2007
- How is medical decision‐making shared? The case of haemophilia patients and doctors: the aftermath of the infected blood affair in FranceHealth Expectations, 2003