Author of

• 15616

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  P3.11 - Poster Session/ Palliative and Supportive Care (ID 231)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Palliative and Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15628

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    P3.11-012 - Improving Clinical Trial Awareness in NSCLC: Pilot Testing a Novel Healthcare IT Platform for Incorporating Education at the Point of Care (ID 3253)

    09:30 - 09:30  |  Author(s): W. Dudley
    • Abstract

    Background:
    Cancer clinical trial (CCT) participation is critical to improving the care of patients with Non-Small Cell Lung Cancer (NSCLC), yet low participation in CCTs persists. Little is known about the specific barriers to CCT participation among patients with NSCLC. The On Q Care Planning System (CPS) is an electronic tablet based platform adapted to address potential barriers to CCT participation through algorithm-driven identification of and education about patient specific CCTs at the point of care. The primary objectives of this study were to 1) characterize knowledge, attitudes and beliefs about CCTs among patients with NSCLC and their providers and 2) evaluate the impact of the CPS on CCT participation.
    
    Methods:
    We performed a multi-site pilot implementation project of CPS as a clinical decision support and patient education tool. Patients were eligible if they had recurrent/metastatic NSCLC. The CPS contained clinical trial eligibility criteria for many CCTs in NSCLC open at the primary research site, as well as selected CCTs from surrounding cancer centers. Study aims were evaluated using patient and provider self-report surveys. Knowledge, attitudes and beliefs about CCTs for both patient’s and provider’s was captured through self-assessment surveys, using a combination of true/false questions and 1-5 Likert scale measures where 5 indicated highest level of agreement. Effect of CPS on CCT enrollment was measured by rate of enrollment in CCTs following the intervention, compared to historical rates of NSCLC CCT participation at our institution.
    
    Results:
    From April 2015 through July 2015, 9 providers (medical oncologists and nurse practitioners) and 79 patients with recurrent/metastatic NSCLC have been enrolled from 2 participating cancer centers. While providers reported being aware of open CCTs (mean score (m)=4.6), they felt that lack of adequate information about CCTs (m=3.0) and having time to review eligibility (m=2.6) were key barriers to CCT enrollment. Patients agreed that there were both the personal (m=3.7) and societal (m=4.1) benefits of CCTs. Similar to providers, key barriers to CCT participation for patients centered around lack of knowledge (concern about not knowing what drug they would receive (m=3.5) and that CCT agents would be too toxic (m=3.2)). Of the patients enrolled, 22 were at a point of new treatment or change in treatment and thus evaluable for rate of CCT referral and enrollment. In this subgroup, 21 (95.5%) received care plans with CCT recommendations. Following the study intervention visit, 8 (36.4%) of evaluable patients enrolled in a clinical trial. This compares favorably both with historical rates at our institution, where 13.8% of treatment eligible patients with lung cancer have been enrolled in CCTs, and with national averages which are less than 5%.
    
    Conclusion:
    CCT enrollment is critical to advancing the treatment of NSCLC, yet CCT enrollment in NSCLC remains low. For both providers and patients, the lack of readily accessible information about clinical trial eligibility and protocol details is a major barrier to CCT enrollment. The CPS is specifically designed to address these barriers. Indeed, in this pilot study, we showed a promising rate of CCT accrual with the use of the CPS. These findings should be validated in larger, randomized studies.