Title

Accrual Barriers in Cancer Clinical Trials: A Strategy Assessment

Document Type

Presentation

Publication Date

12-4-2014

Comments

Capstone Advisor: Amy Leader, DrPH, MPH, Thomas Jefferson University

Abstract

In the United States, 1.2 million Americans are diagnosed with cancer annually and only 2.5% of adult cancer patients are enrolled into clinical trials. The purpose of this research was to assess clinical trial recruitment strategies through key informant interviews with physicians and clinical trials coordinators (CTCs) to identify best practices and strategies for patient recruitment among National Cancer Institute (NCI)-designated cancer institutions. Findings were compared and contrasted among the selected cancer centers, as well as physicians and CTCs, in order to provide a recommendation for a comprehensive approach to clinical trial recruitment. One physician and one CTC were identified and interviewed at eight selected NCI-designated institutions. Interviewees were asked how their patients become aware and learn about available clinical trials, barriers faced by patients and physicians, potential strategies for the elimination of barriers, and the recruitment of underrepresented populations. A qualitative analysis was performed using a thematic, descriptive approach. This research found most patients learn about available clinical trials through their medical oncologist and the Internet. Patient barriers included: transportation, time, cost, lack of knowledge and understanding about clinical trials. Physician barriers included: time, regulatory requirements, logistical challenges, and cultural/language barriers. Recruitment of underrepresented populations was not a priority at any of the institutions. Streamlining regulatory requirements, legislative mandates, and cultural competency training were suggested as ways to increase participation in trials. Various forms of marketing were used to promote awareness among patients such as posters, mailers, and community seminars. Based on this research, a recommendation for a comprehensive approach to cancer clinical trial recruitment would be to mandate, at a federal level, that insurance companies cover all patient costs associated with participating in a trial and institute, at a local level, a requirement that all physicians complete cultural competency training and maintain a presence within the community.

Presentation: 22 minutes