Attitudes about and factors associated with discussion and recommendation of cancer clinical trials: Results from a survey of 1,030 oncologists

Authors: Nair RG; Lee SJC; Murphy CC; Geiger AM; Gerber DE; Skinner CS

Category: Behavioral Science & Health Communication
Conference Year: 2020

Abstract Body:
Purpose of the study: Accrual to cancer clinical trials is sub-optimal. To understand oncologist and practice-level barriers to trial participation, we surveyed 1,030 oncology providers. Here we describe their perspectives about current and expected trial-related responsibilities and factors associated with discussion and recommendation of cancer clinical trials. Methods: The survey measured physician demographics, practice characteristics, reported rates of discussion and recommendation of trials, perceived barriers to enrollment, and beliefs about clinical trials. Descriptive statistics were used to report demographic and practice characteristics, and beliefs about barriers and clinical trials. We also used multivariate logistic regression to assess associations of oncologist and practice characteristics with reported discussion and recommendation of clinical trials (to more than 25% patients in the past 5 years). Results: Most important perceived barriers to enrollment included physician and staff time and effort, procedural factors (assessing eligibility, access to archival tissue, informed consent process), and administrative activities. Although 69% reported performing procedural activities such as identifying, matching, consenting, and enrolling patients, 43% thought that, ideally, research staff would perform these tasks. However, 81% wanted to continue their responsibility of explaining standard treatment and trial protocol to patients. 47% said their organizational leadership encouraged trial recruitment and 59% perceived their leadership provided resources and infrastructure for recruitment. There was near universal agreement (92%) that offering and discussing trials is an important aspect of providing high-quality care. Higher odds of reporting both discussion and recommendation of trials were associated with younger age, membership in professional societies, participation in cancer research cooperative groups, and prior training on trial design. Surprisingly, neither patient insurance nor physician-reported barriers to enrollment was associated with trial discussion or recommendation. Conclusions: Results are useful to understand and improve organizational efforts to optimize integration of clinical trial recruitment into oncologist best practices

Keywords: oncologist survey clinical trial recruitment