Exploring Australian regional cancer patients' experiences of clinical trial participation via telehealth.

INTRODUCTION: Regional cancer patients face various barriers in accessing specialist cancer services. Teletrials are a new model of care that utilise communications technologies to enable access to and participation in clinical trials close to home. The present study aimed to explore the experiences of regional cancer patients and their carers while participating in a teletrial, and those of regional patients who travelled to a metropolitan centre for trial participation. METHODS: A concurrent, mixed methods study design was used to address the study aim. Patient quality of life data were gathered for both groups and an audio-recorded semi-structured interview undertaken to explore patients' and carers' experiences of the two modes of trial participation. Greater weighting was given to the qualitative data. RESULTS: Participants described teletrials as an acceptable and valuable initiative that reduced overall burden of trial participation. Irrespective of mode of delivery, patients and carers identified access to trials and specialist cancer services as an important equity issue for regional cancer patients. DISCUSSION: From the perspective of regional cancer patients and carers, a teletrial offers convenient, acceptable access to a clinical trial. Although not all patients may want to engage in a teletrial, patients and carers agree that it offers equity of opportunity for trial participation, irrespective of where people live.

Differences in glucose values obtained from point-of-care glucose meters and laboratory analysis in critically ill patients.

BACKGROUND: Blood for glucose analysis is often obtained interchangeably from indwelling catheters and fingersticks. OBJECTIVES: To determine the level of agreement between glucose values obtained by laboratory analysis and with a point-of-care device for blood from 2 different sources: fingerstick and a central venous catheter. METHODS: A method-comparison design was used. Point-of-care values for blood from fingersticks and catheters were compared with laboratory values for blood from catheters in a convenience sample of 67 critically ill patients. The effects of hematocrit level and finger edema on differences in glucose values between the 2 methods were also evaluated. A t test was used to determine differences in glucose values obtained via the 2 methods. Differences and limits of agreement were also calculated. RESULTS: Laboratory glucose values for blood from a catheter differed significantly from point-of-care values for blood from the catheter (t(1,66) = -9.18; P < .001) and from a fingerstick (t(1,66) = 6.53; P < .001). Glucose values for the 2 methods differed by 20 mg/dL or more for 1 of 6 patients (15%) for catheter samples and for 1 of 5 (21%) for fingerstick samples. Point-of-care glucose values for fingerstick and catheter samples did not differ (P = .98). Hematocrit level significantly explained the difference in glucose values between the 2 methods for both catheter (R(2) = 0.288; P < .001) and fingerstick (R(2) = 0.280; P = .02) samples. CONCLUSIONS: Use of a commonly used point-of-care device when precise glucose values are needed may lead to faulty treatment decisions.