The New York City Research and Improvement Networking Group (NYC RING)

Enhancing Primary Care Physicians' Capacity to Improve Cancer Patients' Access to Therapeutic Clinical Trials

This study aims to increase patient access to and participation in cancer clinical trials with the use of qualitative and quantitative surveys which will be used to modify existing web-based cancer clinical trials educational training programs for community-based primary care physicians.

Participating Practices
Memorial Sloan Kettering Cancer Center (MSKCC)
City College of New York (CCNY)

Principal Investigator
Elisa S Weiss, PhD

Project Timeline
Launch: Spring 2011
Data Collection: Current

Study Overview
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 and do not consider access to trials when they refer patients for cancer treatment.
In CCT-Link: Enhancing Primary Care Physicians’ Capacity to Improve Cancer Patients’ Access to Therapeutic Clinical Trials (CCT-Link), we will tailor and enhance a web-based cancer clinical trials educational training for community-based primary care physicians (PCPs) in New York City who serve predominantly low-income minority patients.  Modifications to an existing training will be based on qualitative and quantitative research with over 300 PCPs; 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.  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 access to and participation in cancer clinical trials, particularly among underrepresented groups.

Contact information:
Elisa Weiss, PhD, elisa.weiss@einstein.yu.edu

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