The Wednesday AccrualNet Post (2-2-2011) Talking with patients about a clinical trial
Originally posted by: Rose Mary Padberg, NCI AccrualNet Team Member on the former AccrualNet site on Feb 02, 2011.
We frequently hear, and readily observe, that physicians are the gatekeepers for clinical trial enrollment. The physician naturally has a great deal of medical authority and knowledge and is the key point for information on treatment options at the time of diagnosis or a change in treatment plan.
Research has shown that these interactions are often less than ideal and that the option of a clinical trial is not frequently mentioned. In fact it has been estimated that only 20% of eligible patients are offered a trial. This statistic has been found to be true even at top cancer research institutions. However, when offered a trial by their doctor, 75% of patients will enroll. It all comes down to a conversation between a patient and a doctor.
Many reasons have been given as to why this important clinical trial conversation so seldom occurs. Some of the reasons are out of our control such as inability to find a trial, disagreement with the protocol’s randomization, lack of compensation, etc. However, we can possibly assist in alleviating one barrier. That being the barrier of the physician not knowing how to start the conversation about a trial. We can include information about clinical trials in introductory letters to patients to let them know that your institution is involved in clinical research. By providing clinical trial educational materials in waiting rooms, hanging NCI clinical trial posters, and showing the NCI DVD, “Understanding Cancer Clinical Trials", all support patients awareness of this being part of appropriate care. It will help to make the treatment conversation with the physician easier. The patient may even be the one to bring up the request for a trial if the physician does not. The important thing is that we are trying to normalize the inclusion of this discussion. There may not be a trial that fits the patient’s condition, but it is important that this option was included as part of the treatment discussion.
Please share what you have tried to ease the discussion of the option of clinical trials.