We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine

Caregiver survey in glioblastoma focused on cognitive dysfunction: development and results from a multicenter study

    Trang H Au

    *Author for correspondence: Tel.: +1 801 587 9730;

    E-mail Address: trang.au@hci.utah.edu

    Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA

    ,
    Connor Willis

    Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA

    ,
    Maija Reblin

    Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA

    ,
    Katherine B Peters

    The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC 27110, USA

    ,
    Phioanh Leia Nghiemphu

    Department of Neurology, University of California, Los Angeles, Los Angeles, CA 90095, USA

    ,
    Jennie W Taylor

    Departments of Neurology & Neurological Surgery, University of California, San Francisco, CA 94143, USA

    ,
    Howard Colman

    Department of Neurosurgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA

    ,
    Adam L Cohen

    Inova Schar Cancer Institute, Fairfax, VA 22031, USA

    ,
    David Ryan Ormond

    Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO 80045, USA

    ,
    Elizabeth C Neil

    Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA

    ,
    Arnab Chakravarti

    Department of Radiation Oncology, The Ohio State University College of Medicine, Columbus, OH 43210, USA

    ,
    Nicole Willmarth

    American Brain Tumor Association, Chicago, IL 60631, USA

    ,
    Bea Christine Balajonda

    The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC 27110, USA

    ,
    Jyothi Menon

    Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA

    ,
    Junjie Ma

    Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA

    ,
    Hillevi Bauer

    Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA

    , ,
    Malinda S Tan

    Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA

    ,
    Prianka Singh

    Bristol Myers Squibb, Princeton, NJ 08540, USA

    ,
    Alexander Marshall

    Bristol Myers Squibb, Princeton, NJ 08540, USA

    ,
    Beata Korytowsky

    Mirati Therapeutics, San Diego, CA 92121, USA

    ,
    David Stenehjem

    Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA

    Department of Pharmacy Practice & Pharmaceutical Sciences, College of Pharmacy, University of Minnesota, Duluth, MN 55812, USA

    &
    Diana Brixner

    Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA

    Published Online:https://doi.org/10.2217/fon-2022-0904

    Aim: To develop a cognitive dysfunction (CD) focused questionnaire to evaluate caregiver burden in glioblastoma. Materials & methods: The survey was developed from stakeholder consultations and a pilot study, and disseminated at eight US academic cancer centers. Caregivers self-reported caring for an adult with glioblastoma and CD. Results: The 89-item survey covered demographics, CD symptoms and caregiver burden domains. Among 185 caregivers, most were white, educated females and reported memory problems as the most common CD symptom. An exposure-effect was observed, with increase in number of CD symptoms significantly associated with greater caregiver burden. Conclusion: This questionnaire could guide caregiver interventions and be adapted for use longitudinally, in community cancer settings, and in patients with brain metastases.

    Plain language summary

    Glioblastoma (GBM) is a very aggressive brain cancer. People who have GBM have trouble remembering things and are unable to do things they used to do. These changes can be very hard. Researchers are trying to better understand what it is like for people who take care of people with GBM (or caregivers). In this study, researchers created a new survey for caregivers. The survey included questions about what caregivers see happening in their loved one with GBM. Caregivers said that memory problems were common. Also, when the patient had more problems the caregiver had a harder time, too. Researchers hope to improve the survey and use it in the future for more studies.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Thakkar JP, Dolecek TA, Horbinski C et al. Epidemiologic and molecular prognostic review of glioblastoma. Cancer Epidemiol. Biomarkers Prev. 23(10), 1985–1996 (2014).
    • 2. Alexander BM, Cloughesy TF. Adult glioblastoma. J. Clin. Oncol. 35(21), 2402–2409 (2017).
    • 3. Davis ME. Glioblastoma: overview of disease and treatment. Clin. J. Oncol. Nurs. 20(Suppl. 5), S2–S8 (2016).
    • 4. Norden AD, Korytowsky B, You M et al. A real-world claims analysis of costs and patterns of care in treated patients with glioblastoma multiforme in the United States. J. Manag. Care Spec. Pharm. 25(4), 428–436 (2019).
    • 5. Jacobs DI, Kumthekar P, Stell BV et al. Concordance of patient and caregiver reports in evaluating quality of life in patients with malignant gliomas and an assessment of caregiver burden. Neuro-Oncol. Pract. 1(2), 47–54 (2014). • Jacobs et al. report on the need for clinician awareness about the divergence between caregivers and the self-reports of patients with glioma. At the same time, they highlight the significant role of the caregiver and the heavy psychosocial burden associated with this role.
    • 6. Russell B, Collins A, Dowling A et al. Predicting distress among people who care for patients living longer with high-grade malignant glioma. Support. Care Cancer 24(1), 43–51 (2016).
    • 7. Guerriere D, Husain A, Zagorski B et al. Predictors of caregiver burden across the home-based palliative care trajectory in Ontario, Canada. Health Soc. Care Community 24(4), 428–438 (2016).
    • 8. Deatrick JA, Hobbie W, Ogle S et al. Competence in caregivers of adolescent and young adult childhood brain tumor survivors. Health Psychol. 33(10), 1103–1112 (2014).
    • 9. Goebel S, von Harscher M, Mehdorn HM. Comorbid mental disorders and psychosocial distress in patients with brain tumours and their spouses in the early treatment phase. Support. Care Cancer 19(11), 1797–1805 (2011).
    • 10. Milbury K, Mallaiah S, Mahajan A et al. Yoga program for high-grade glioma patients undergoing radiotherapy and their family caregivers. Integr. Cancer Ther. 17(2), 332–336 (2018).
    • 11. Sterckx W, Coolbrandt A, Dierckx de Casterlé B et al. The impact of a high-grade glioma on everyday life: a systematic review from the patient's and caregiver's perspective. Eur. J. Oncol. Nurs. 17(1), 107–117 (2013). • By including mixed studies, this review reflects the umet need to systematically evaluate the experiences of glioma from the patient perspective and the caregiver perspective. While large themes were consistent among the studies, Sterckx et al. call for a closer look to better understand the differences in order to tailor supportive interventions.
    • 12. Collins A, Lethborg C, Brand C et al. The challenges and suffering of caring for people with primary malignant glioma: qualitative perspectives on improving current supportive and palliative care practices. BMJ Support. Palliat. Care 4(1), 68–76 (2014). • In their prospective study, Collins et al. report on domains of caring that caregivers identified as challenging. There is a focus on the caregiver–patient partnership, which highlights the significant role of the caregiver.
    • 13. McConigley R, Halkett G, Lobb E et al. Caring for someone with high-grade glioma: a time of rapid change for caregivers. Palliat. Med. 24(5), 473–479 (2010).
    • 14. Andrewes HE, Drummond KJ, Rosenthal M, Bucknill A, Andrewes DG. Awareness of psychological and relationship problems amongst brain tumour patients and its association with carer distress. Psychooncology 22, 2200–2205 (2013).
    • 15. Aoun SM, Deas K, Howting D, Lee G. Exploring the support needs of family caregivers of patients with brain cancer using the CSNAT: a comparative study with other cancer groups. PLOS ONE 10, e0145106 (2015).
    • 16. Barakat LP, Li Y, Hobbie WL et al. Health-related quality of life of adolescent and young adult survivors of childhood brain tumors. Psychooncology 24, 804–811 (2015).
    • 17. Bayen E, Laigle-Donadey F, Prouté M, Hoang-Xuan K, Joël ME, Delattre JY. The multidimensional burden of informal caregivers in primary malignant brain tumor. Support. Care Cancer 25, 245–253 (2017).
    • 18. Beek L, Schappin R, Gooskens R, Huisman J, Jongmans M. Surviving a brain tumor in childhood: impact on family functioning in adolescence. Psychooncology 24, 89–94 (2015).
    • 19. Boele FW, Given CW, Given BA et al. Family caregivers' level of mastery predicts survival of patients with glioblastoma: a preliminary report. Cancer 123, 832–840 (2017).
    • 20. Boele FW, Heimans JJ, Aaronson NK et al. Health-related quality of life of significant others of patients with malignant CNS versus non-CNS tumors: a comparative study. J. Neuro-Oncol. 115, 87–94 (2013).
    • 21. Boele FW, Verdonck-de Leeuw IM, Cuijpers P, Reijneveld JC, Heimans JJ, Klein M. Internet-based guided self-help for glioma patients with depressive symptoms: design of a randomized controlled trial. BMC Neurol. 14, 81 (2014).
    • 22. Bradley SE, Sherwood PR, Kuo J et al. Perceptions of economic hardship and emotional health in a pilot sample of family caregivers. J. Neuro-Oncol. 93, 333–342 (2009).
    • 23. Cheng YH, Lieu AS, Liu Y, Chen HM. Exploring the care needs of primary caregivers of patients awaiting brain tumor surgery and related factors [Chinese]. Hu Li Za Zhi 63, 31–41 (2016).
    • 24. Chien LY, Lo LH, Chen CJ, Chen YC, Chiang CC, Chao YMY. Quality of life among primary caregivers of Taiwanese children with brain tumor. Cancer Nurs. 26, 305–311 (2003).
    • 25. Choi CWJ, Stone RA, Kim KH et al. Group-based trajectory modeling of caregiver psychological distress over time. Ann. Behav. Med. 44, 73–84 (2012).
    • 26. Choi EK, Yoon SJ, Kim JH, Park HJ, Kim JY, Yu ES. Depression and distress in caregivers of children with brain tumors undergoing treatment: psychosocial factors as moderators. Psychooncology 25, 544–550 (2016).
    • 27. Deatrick JA, Hobbie W, Ogle S et al. Competence in caregivers of adolescent and young adult childhood brain tumor survivors. Health Psychol. 33, 1103–1112 (2014).
    • 28. Finocchiaro CY, Petruzzi A, Lamperti E et al. The burden of brain tumor: a single-institution study on psychological patterns in caregivers. J. Neuro-Oncol. 107, 175–181 (2012).
    • 29. Goebel S, von Harscher M, Mehdorn HM. Comorbid mental disorders and psychosocial distress in patients with brain tumours and their spouses in the early treatment phase. Support. Care Cancer 19, 1797–1805 (2011).
    • 30. Hutchinson KC, Willard VW, Hardy KK, Bonner MJ. Adjustment of caregivers of pediatric patients with brain tumors: a cross-sectional analysis. Psycho-Oncology 18, 515–523 (2009).
    • 31. Jacobs DI, Kumthekar P, Stell BV et al. Concordance of patient and caregiver reports in evaluating quality of life in patients with malignant gliomas and an assessment of caregiver burden. Neuro-Oncol. Pract. 1, 47–54 (2014).
    • 32. Janda M, Steginga S, Dunn J, Langbecker D, Walker D, Eakin E. Unmet supportive care needs and interest in services among patients with a brain tumour and their carers. Patient Educ. Couns. 71, 251–258 (2008).
    • 33. Jiang Y, Terhorst L, Donovan HS et al. Locke-Wallace short marital-adjustment test: psychometric evaluation in caregivers for persons with primary malignant brain tumor. J. Nurs. Meas. 21, 502–515 (2013).
    • 34. Keir ST. Levels of stress and intervention preferences of caregivers of brain tumor patients. Cancer Nurs. 30, E33–39 (2007).
    • 35. Keir ST, Guill AB, Carter KE, Boole LC, Gonzales L, Friedman HS. Differential levels of stress in caregivers of brain tumor patients – observations from a pilot study. Support. Care Cancer 14, 1258–1261 (2006).
    • 36. Leclair T, Carret AS, Samson Y, Sultan S. Stability and repeatability of the Distress Thermometer (DT) and the Edmonton Symptom Assessment System-Revised (ESAS-r) with parents of childhood cancer survivors. PLOS ONE 11, e0159773 (2016).
    • 37. Linendoll NM. Family caregivers' perceived symptom distress of persons with a primary malignant brain tumor (thesis): Boston College, William F. Connell School of Nursing. https://dlib.bc.edu/islandora/object/bc-ir:101776 (2008).
    • 38. Locke DE, Cerhan JH, Wu W et al. Cognitive rehabilitation and problem-solving to improve quality of life of patients with primary brain tumors: a pilot study. J. Support. Oncol. 6, 383–391 (2008).
    • 39. Lucas MS, Brawner BM, Hardie TL et al. Assessing suicidal ideation and behaviors among survivors of childhood brain tumors and their mothers during sociobehavioral research. Oncol. Nurs. Forum 42, E319–329 (2015).
    • 40. Mezue WC, Draper P, Watson R, Mathew BG. Caring for patients with brain tumor: the patient and care giver perspectives. Niger J. Clin. Pract. 14, 368–372 (2011).
    • 41. Milbury K, Mallaiah S, Mahajan A et al. Yoga program for high-grade glioma patients undergoing radiotherapy and their family caregivers. Integr. Cancer Ther. 17, 332–336 (2018).
    • 42. Newberry A, Kuo J, Donovan H et al. Identifying family members who are likely to perceive benefits from providing care to a person with a primary malignant brain tumor. Oncol. Nurs. Forum 39, E226–232 (2012).
    • 43. Ownsworth T, Goadby E, Chambers SK. Support after brain tumor means different things: family caregivers' experiences of support and relationship changes. Front. Oncol. 5, 33 (2015).
    • 44. Parvataneni R, Polley MY, Freeman T et al. Identifying the needs of brain tumor patients and their caregivers. J. Neuro-Oncol. 104, 737–744 (2011).
    • 45. Pawl JD, Lee SY, Clark PC, Sherwood PR. Sleep characteristics of family caregivers of individuals with a primary malignant brain tumor. Oncol. Nurs. Forum 40, 171–179 (2013).
    • 46. Petruzzi A, Finocchiaro CY, Lamperti E, Salmaggi A. Living with a brain tumor: reaction profiles in patients and their caregivers. Support. Care Cancer 21, 1105–1111 (2013).
    • 47. Pollock EA, Litzelman K, Wisk LE, Witt WP. Correlates of physiological and psychological stress among parents of childhood cancer and brain tumor survivors. Acad. Pediatr. 13, 105–112 (2013).
    • 48. Quast LF, Turner EM, McCurdy MD, Hocking MC. Health-related quality of life in parents of pediatric brain tumor survivors at the end of tumor-directed therapy. J. Psychosoc. Oncol. 34, 274–290 (2016).
    • 49. Romero MM, Flood LS, Gasiewicz NK, Rovin R, Conklin S. Validation of the National Institutes of Health Patient-Reported Outcomes Measurement Information System Survey as a quality-of-life instrument for patients with malignant brain tumors and their caregivers. Nurs. Clin. North Am. 50, 679–690 (2015).
    • 50. Russell B, Collins A, Dowling A et al. Predicting distress among people who care for patients living longer with high-grade malignant glioma. Support. Care Cancer 24, 43–51 (2016).
    • 51. Sato I, Higuchi A, Yanagisawa T et al. Development of the Japanese version of the Pediatric Quality of Life Inventory™ brain tumor module. Health Qual. Life Outcomes 8, 38 (2010).
    • 52. Sato I, Higuchi A, Yanagisawa T et al. Factors influencing self- and parent-reporting health-related quality of life in children with brain tumors. Qual. Life Res. 22, 185–201 (2013).
    • 53. Scaratti C, Leonardi M, Saladino A et al. Needs of neuro-oncological patients and their caregivers during the hospitalization and after discharge: results from a longitudinal study. Support. Care Cancer 25, 2137–2145 (2017).
    • 54. Seekatz B, Lukasczik M, Löhr M et al. Screening for symptom burden and supportive needs of patients with glioblastoma and brain metastases and their caregivers in relation to their use of specialized palliative care. Support. Care Cancer 25, 2761–2770 (2017).
    • 55. Sherwood PR, Given BA, Given CW et al. Predictors of distress in caregivers of persons with a primary malignant brain tumor. Res. Nurs. Health 29, 105–120 (2006).
    • 56. Trad W, Koh ES, Daher M et al. Screening for psychological distress in adult primary brain tumor patients and caregivers: considerations for cancer care coordination. Front. Oncol. 5, 203 (2015).
    • 57. Passmore C, Dobbie AE, Parchman M et al. Guidelines for constructing a survey. Fam. Med. 34(4), 281–286 (2002).
    • 58. Dillman DA, Smyth JD, Christian LM. (4th Edition). John Wiley & Sons Inc (2014).
    • 59. Taherdoost H. Determining sample size; how to calculate survey sample size. Int. J. Econ. Mgmt. 2(2), 237–239 (2017).
    • 60. American Brain Tumor Association. Treating a glioblastoma (2020). https://abta.org/treating-a-glioblastoma/
    • 61. Au TH, Willis C, Reblin M et al. Caregiver burden by treatment and clinical characteristics of patients with glioblastoma. [published correction appears in: Support Care Cancer. 2021 Nov 18]. Support. Care Cancer 30(2), 1365–1375 (2022). •• Au et al. in this study examine caregiver burden taking into account patient clinical characteristics. They identify that patient performance status is akey factor in caregiver burden, and note that supportive measures for caregivers should be guided by this.
    • 62. Campanella F, Del Missier F, Shallice T et al. Localizing memory functions in brain tumor patients: anatomical hotspots over 260 patients. World Neurosurg. 120, e690–e709 (2018).
    • 63. Day J, Gillespie DC, Rooney AG et al. Neurocognitive deficits and neurocognitive rehabilitation in adult brain tumors. Curr. Treat. Options Neurol. 18(5), 22 (2016).
    • 64. Johnson DR, Wefel JS. Relationship between cognitive function and prognosis in glioblastoma. CNS Oncol. 2(2), 195–201 (2013).
    • 65. Tucha O, Smely C, Preier M et al. Cognitive deficits before treatment among patients with brain tumors. Neurosurgery 47(2), 324–334 (2000).
    • 66. Sharma N, Chakrabarti S, Grover S. Gender differences in caregiving among family – caregivers of people with mental illnesses. World J. Psychiatry 6(1), 7–17 (2016).
    • 67. National Alliance for Caregiving. Cancer caregiving in the U.S.: an intense, episodic, and challenging care experience (2016). www.caregiving.org/wp-content/uploads/2020/05/CancerCaregivingReport_FINAL_June-17-2016.pdf
    • 68. Solanki C, Sadana D, Arimappamagan A et al. Impairments in quality of life and cognitive functions in long-term survivors of glioblastoma. J. Neurosci. Rural Pract. 8(2), 228–235 (2017).
    • 69. Schubart JR, Kinzie MB, Farace E. Caring for the brain tumor patient: family caregiver burden and unmet needs. Neuro-Oncol. 10(1), 61–72 (2008).
    • 70. Mukand JA, Blackinton DD, Crincoli MG et al. Incidence of neurologic deficits and rehabilitation of patients with brain tumors. Am. J. Phys. Med. Rehabil. 80(5), 346–350 (2001).
    • 71. Formica V, Del Monte G, Giacchetti I et al. Rehabilitation in neuro-oncology: a meta-analysis of published data and a mono-institutional experience. Integr. Cancer Ther. 10(2), 119–126 (2011).
    • 72. Bartolo M, Zucchella C, Pace A et al. Early rehabilitation after surgery improves functional outcome in inpatients with brain tumours. J. Neuro-Oncol. 107, 537–544 (2012).
    • 73. Sherwood PR, Cwiklik M, Donovan HS. Neuro-oncology family caregiving: review and directions for future research. CNS Oncol. 5(1), 41–48 (2016). •• This large review identifies the high distress experienced by caregivers in neuro-oncology. Sherwood et al. call for future studies that include multisite studies with larger sample sizes and that use common measurement tools.
    • 74. Boele FW, Given CW, Given BA et al. Family caregivers' level of mastery predicts survival of patients with glioblastoma: a preliminary report. Cancer 123(5), 832–840 (2017). •• This study was GBM-specfic. The finding that caregiver mastery can affect patient survival is impactful, and underlies the importance of supporting caregivers for the well-being of caregivers and the (survival) benefit of patients.
    • 75. Dunning D, Heath C, Suls JM. Flawed self-assessment: implications for health, education, and the workplace. Psychol. Sci. Public Interest. 5(3), 69–106 (2004).
    • 76. Levy AG, Scherer AM, Zikmund-Fisher BJ et al. Prevalence of and factors associated with patient nondisclosure of medically relevant information to clinicians. JAMA Netw. Open 1(7), e185293 (2018).
    • 77. Finocchiaro CY, Petruzzi A, Lamperti E et al. The burden of brain tumor: a single-institution study on psychological patterns in caregivers. J. Neuro-Oncol. 107(1), 175–181 (2012).
    • 78. Stell BV, Jacobs B, Grimm et al. Quality-of-life concordance between patients with malignant gliomas and their caregivers: updated data. J. Clinical Oncol. 29(Suppl. 15), 9053 (2011).
    • 79. Ford E, Catt S, Chalmers A et al. Systematic review of supportive care needs in patients with primary malignant brain tumors. Neuro-Oncol. 14(4), 392–404 (2012).
    • 80. Longacre ML. Cancer caregivers information needs and resource preferences. J. Cancer Educ. 28(2), 297–305 (2013).
    • 81. Van den Borg R, Weerdesteijn-Prinsen A, Nijboer CM, OS09.3. A Caregiver burden of glioma patients: the impact of informal care. Neuro-Oncol. 23(S2), ii12 (2021).
    • 82. Siefert ML, Williams AL, Dowd MF et al. The caregiving experience in a racially diverse sample of cancer family caregivers. Cancer Nurs. 31(5), 399–407 (2008).
    • 83. Martin MY, Sanders S, Griffin JM et al. Racial variation in the cancer caregiving experience: a multisite study of colorectal and lung cancer caregivers. Cancer Nurs. 35(4), 249–256 (2012).
    • 84. Fenton ATHR, Ornstein KA, Dilworth-Anderson P et al. Racial and ethnic disparities in cancer caregiver burden and potential sociocultural mediators. Support. Care Cancer 30(11), 9625–9633 (2022). •• Fenton et al. clearly demonstrate the disparities among Black/Hispanic caregivers compared with White caregivers. These findings have implications for support frameworks, clinical practice and policy making.
    • 85. van der Meulen M, Dirven L, Habets EJJ et al. Cognitive functioning and health-related quality of life in patients with newly diagnosed primary CNS lymphoma: a systematic review. Lancet Oncol. 19(8), e407–e418 (2018). • This study examines patient characteristics and clinical characteristics, e.g. tumor size, radiation treatment, on patient cognitive dysfunction andquality of life. van der Meulen et al. advocate for including the effects of these characteristicts in decision-making.
    • 86. Dombestein H, Norheim A, Lunde Huseb⊘AM. Understanding informal caregivers' motivation from the perspective of self-determination theory: an integrative review. Scand. J. Caring Sci. 34(2), 267–279 (2020).
    • 87. Sheridan R, Martin-Kerry J, Hudson J et al. Why do patients take part in research? An overview of systematic reviews of psychosocial barriers and facilitators [published correction appears in Trials. 2020 Oct 8;21(1):840]. Trials 21(1), 259 (2020).