ONCOLOGISTS' ATTITUDES AND BELIEFS ABOUT PATIENT PARTICIPATION IN CANCER CLINICAL TRIALS

Purpose: Participation in cancer clinical trials is very low. The purpose of this research was to determine how oncology health care providers view patient participation in cancer clinical trials, and what they believe are barriers to participation both at a patient and institutional level.

Method: We conducted a mailed survey targeting all oncology health care providers (n=325) who were members of the Florida Society of Clinical Oncology. A single mailed survey was sent, along with a small gift. Survey questions included: sociodemographic characteristics, attitudes towards clinical trials, and beliefs about what patient and institutional factors affect participation.

Result: 55 surveys were returned as undeliverable, and 62 usable surveys were received. Responders were 69% male, 82% White, 18% Hispanic, and averaged 53.7 (st. dev. 9.9) years. About half (52%) were in private practice, 87% reported cancer clinical trials at their institution, and 33% of these reported enrolling 30 or more patients per year. Referral (69% of respondents) was the most commonly noted method of identifying potential participants; only 3% cited automated rapid assessment as being used. Oncologists (95%) and research nurses (63%) most commonly determined eligibility.  Providers’ general impression of clinical trials was very favorable, with 31% responding as “positive” and 66% as “very positive.” In addition 77% thought that patients should participate in a trial if one were available. At least 75% of providers cited trust in the health care system and a good physician relationship as very to extremely important for patients when deciding about participation. Contrary to what we found in a patient survey, providers did not view as important: insurance coverage, transportation, wanting to help improve treatments, and not wanting to feel like a guinea pig. The most commonly cited study/institutional barriers were: failed eligibility, and no protocol available. The factor cited as most likely to improve enrollment was research nurse support.

Conclusion: Oncology health care providers are very supportive of participation in cancer clinical trials, and articulated many institutional and patient barriers to participation. There are some striking differences between providers and patients in the importance given to some factors affecting participation. Respondents stressed the role of the research nurse in improving enrollment rates. These findings can be used to develop pilot intervention studies for improving recruitment into cancer clinical trials.