CCT-Link: Enhancing Primary Care Physicians' Capacity to Improve Cancer Patients' Access to Therapeutic Clinical Trials
Maria Binz-Scharf, PhD, Carma Bylund, PhD, and Elisa Weiss, PhD
Despite an emphasis on broad representation in cancer clinical trials over the past 15 years, little progress has been made in breaking down barriers to participation. Although about 20 percent of cancer patients are medically eligible for a therapeutic clinical trial, adult trial participation remains at about 2.5-3%. This rate is even lower among racial and ethnic minorities and the medically underserved. The low accrual rate in therapeutic cancer clinical trials has a profound effect on the quality of research and generalizability of results, and perpetuates disparities in quality of care. Studies have found that cancer patients continue to know very little about clinical trials, and the majority of patients who participate in a cancer clinical trial report that information from a physician influenced their decision. Because primary care physicians (PCPs) are a trusted source of information and often interact with cancer patients during diagnosis and treatment, PCPs can play an important role in increasing patients’ awareness of clinical trials and serving as a gateway to trial access. Nonetheless, many PCPs feel ill-equipped to talk with patients about clinical trials. In CCT-Link: Enhancing Primary Care Physicians’ Capacity to Improve Cancer Patients’ Access to Therapeutic Clinical Trials (CCTLink), we propose to tailor and enhance an evidence-based cancer clinical trials training for community-based primary care physicians (PCPs) in New York City who participate in one managed care plan and serve underrepresented patients. Modifications to the existing training will be based on qualitative and quantitative research with over 300 PCPs in the same managed care plan; this research will be designed to identify their knowledge, attitudes, and beliefs about cancer treatment trials; past use of clinical trial information in their practice; and existing relationships and referral patterns between these PCPs and oncologists, particularly clinical trial providers. The purpose of the web-based and in-person pilot training, conducted by national experts and local oncologists who conduct trials, will be to increase PCPs’ knowledge and capacity to speak with cancer patients about referrals to clinical trials. We will conduct a panel survey and qualitative interviews to evaluate how much our training increases the capacity and willingness of 75 PCPs to: talk with patients about therapeutic cancer clinical trials, provide support to patients interested in learning more about clinical trials, and refer patients to oncology settings that conduct clinical trials, thereby increasing underrepresented patients’ access to care. Our broader purpose with this CCT-Link pilot project is to use these findings to develop a larger intervention study for PCPs and clinical trial providers to achieve increased patient participation in cancer clinical trials, particularly among underrepresented groups.
Binz-Scharf M., Weiss E., Bylund C, Michaels M, Blakeney N, Lounsbury D, Patel S, Hall D. CCT-Link: Enhancing Primary Care Physicians' Capacity to Improve Cancer Patients' Access to Therapeutic Clinical Trials. NYC Research and Improvement Networking Group (NYC RING)