Breaking Down Barriers to Improve Patient Clinical Trial Participation

I am excited to be working on a webinar next month with Pia Banerjee, PhD

Director, Cancer Innovation & Transformation, American Cancer Society, and Mark Fleury, PhD, Principal, Policy Development, Emerging Science, American Cancer Society will break down the barriers of care to improve patient clinical trial participation. By addressing barriers to care, more patients will have access to clinical trials, leading to better treatment options and improved cancer care.

Barriers to care affect anyone with Cancer. It is contingent on a multitude of variables financial, logistical, systemic, and psychological challenges.  Most patients are going to fall into one of these areas.

The biggest obstacle is being cancer illiterate.  No one prepares or even studies how to be a cancer patient or understands the value of enrollment in cancer clinical trials. These trials are often led to the next best clinical treatment.

What are the barriers to care?

Awareness and Education

Many patients and even healthcare providers are unaware of available clinical trials. Strategies to improve awareness include:

• Patient Education Campaigns: Develop easy-to-understand materials explaining clinical trials, their benefits, and how to enroll.
• Provider Training: Educate oncologists and healthcare professionals on trial options so they can actively discuss them with eligible patients.
• Community Outreach: Engage advocacy groups, social workers, and community organizations to spread awareness in underserved areas.
• Online Trial Registries: Improve accessibility to databases like ClinicalTrials.gov and simplify search features.

Financial Barriers

Financial concerns often prevent patients from participating in clinical trials. There are a few options thar address this concern:

• Insurance Coverage Expansion: Advocate for policies requiring insurers to cover routine care costs for trial participants.
• Financial Assistance Programs: Provide stipends for travel, lodging, and lost wages through sponsors or nonprofit organizations.
• Transparent Cost Discussions: Ensure patients understand which expenses are covered and help them navigate financial aid options.

Logistical Challenges

Patients may face transportation or scheduling difficulties. Solutions include:

• Telehealth and Remote Monitoring: Allow virtual check-ins, reducing the need for frequent hospital visits.
• Local Treatment Centers: Enable participation at nearby clinics instead of requiring travel to major research institutions.
• Transportation Assistance: Offer rides, mileage reimbursement, or travel stipends for patients.
• Flexible Scheduling: Provide after-hours and weekend appointments to accommodate work and family commitments.

Underserved Communities

Many underrepresented groups have historical mistrust in the medical system. This can be one of the biggest roadblocks to seeking care. There are services in place such as:

• Diverse Trial Recruitment: Ensure clinical trials actively recruit diverse populations.
• Community Partnerships: Work with local leaders, churches, and advocacy groups to engage minority and rural populations.
• Culturally Competent Communication: Use language-appropriate materials and hire diverse staff to improve trust.
• Transparent Informed Consent: Clearly explain the risks, benefits, and purpose of trials without coercion.

Enrollment Process

Complex eligibility criteria and administrative burdens deter participation. Some of the strategies to improve this area:

• Broaden Eligibility Criteria: Reduce unnecessary exclusions based on age, pre-existing conditions, or prior treatments.
• Streamline Paperwork: Use electronic consent forms and simplify documentation.
• Patient Navigators: Assign dedicated coordinators to help patients through the trial process.

Physician Engagement

Many oncologists are hesitant to refer patients to trials due to a lack of time or knowledge. Solutions:

• Automated Trial Matching Tools: Implement AI-driven systems that match patients with eligible trials based on medical records.
• Incentives for Physicians: Offer compensation or recognition for trial referrals.
• Embedding Research in Standard Care: Integrate clinical trial discussions into routine oncology visits.

Expanding Access to Rare Cancer and Pediatric Trials

Patients with rare cancers or pediatric patients often struggle to find trials. Ways to improve access:

• Global Collaboration: Increase partnerships between international research institutions.
• Centralized Trial Hubs: Create regional centers specializing in rare cancer trials.
• Expanded Compassionate Use Programs: Provide access to investigational treatments outside traditional trials.

1104Health is a resource that works with patients and oncologists to help them gain access to a wider range of treatment options for all cancers. Please reach out if you need assistance.