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PLoS One. 2015 May 26;10(5):e0128209. doi: 10.1371/journal.pone.0128209. eCollection 2015.

Longitudinal study of informed consent in innovative therapy research: experience and provisional recommendations from a multicenter trial of intracerebral grafting.

Author information

1
AP-HP, Hôpital Henri Mondor, Centre de Référence-Maladie de Huntington, Neurologie cognitive, Créteil, France; Université Paris Est, Faculté de médecine, Créteil, France; INSERM U955, Equipe 01, Neuropsychologie Interventionnelle, Créteil, France; Département d'Etudes Cognitives, Ecole Normale Supérieure, PSL Research University, Paris, France.
2
AP-HP, Hôpital Henri Mondor, Centre de Référence-Maladie de Huntington, Neurologie cognitive, Créteil, France; Université Paris Est, Faculté de médecine, Créteil, France; INSERM U955, Equipe 01, Neuropsychologie Interventionnelle, Créteil, France.
3
CHU d'Angers, Centre de Référence des Maladies Neurogénétiques, service de neurologie, Angers, France; UMR CNRS 6214 INSERM U1083, CHU d'Angers, Angers, France.
4
CHU d'Amiens, service de neurologie, Amiens, France; EA 4559, Laboratoire de Neurosciences Fonctionnelles et Pathologies, Université de Picardie Jules Verne, Amiens, France.
5
Université Lille Nord de France, Lille, France; INSERM UMR837, Institut de Recherches sur le Cancer de Lille (IRCL), Lille, France; CHRU Lille, Département de Neurologie et des Mouvements Anormaux, Lille, France.
6
CHU Nantes, Service de Neurologie, Nantes, France; UFR Médecine, Université de Nantes, Nantes, France.
7
Leenaards Memory Centre, Clinical Neuroscience Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland; INSERM U825, Université de Toulouse, Toulouse, France.
8
Cliniques Universitaires de Bruxelles Hôpital Erasme, Bruxelles, Belgique.
9
AP-HP, Hôpital Henri Mondor, Unité de Recherche Clinique, Creteil, France.

Abstract

BACKGROUND:

There is an urgent need to assess and improve the consent process in clinical trials of innovative therapies for neurodegenerative disorders.

METHODS:

We performed a longitudinal study of the consent of Huntington's disease patients during the Multicenter Fetal Cell Intracerebral Grafting Trial in Huntington's Disease (MIG-HD) in France and Belgium. Patients and their proxies completed a consent questionnaire at inclusion, before signing the consent form and after one year of follow-up, before randomization and transplantation. The questionnaire explored understanding of the protocol, satisfaction with the information delivered, reasons for participating in the trial and expectations regarding the transplant. Forty-six Huntington's disease patients and 27 proxies completed the questionnaire at inclusion, and 27 Huntington's disease patients and 16 proxies one year later.

RESULTS:

The comprehension score was high and similar for Huntington's disease patients and proxies at inclusion (72.6% vs 77.8%; P > 0.1) but only decreased in HD patients after one year. The information satisfaction score was high (73.5% vs 66.5%; P > 0.1) and correlated with understanding in both patients and proxies. The motivation and expectation profiles were similar in patients and proxies and remained unchanged after one year.

CONCLUSIONS:

Cognitively impaired patients with Huntington's disease were capable of consenting to participation in this trial. This consent procedure has presumably strengthened their understanding and should be proposed before signing the consent form in future gene or cell therapy trials for neurodegenerative disorders. Because of the potential cognitive decline, proxies should be designated as provisional surrogate decision-makers, even in competent patients.

PMID:
26010368
PMCID:
PMC4444138
DOI:
10.1371/journal.pone.0128209
[Indexed for MEDLINE]
Free PMC Article

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