Science in the Heartland: Exploring determinants of offering cancer clinical trials in rural-serving community urology practices

•Nonmetropolitan community urology practices present important opportunities to increase cancer clinical trial accrual.•Even in communities with available cancer clinical trials, practices have limited awareness of trials because they lack social connections with trial investigators.•Rural-serving u...

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Vydáno v:Urologic oncology Ročník 37; číslo 8; s. 529.e9 - 529.e18
Hlavní autoři: Ellis, Shellie D., Geana, Mugur, Mackay, Christine B., Moon, Deborah J., Gills, Jessie, Zganjar, Andrew, Brekke, Gayle, Thrasher, J. Brantley, Griebling, Tomas L.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Inc 01.08.2019
Témata:
Cancer care delivery
Clinical trials
Community practice
Implementation science
Physician recommendation
Urological cancer
Community practice
Clinical trials
Urological cancer
Implementation science
Cancer care delivery
Physician recommendation
ISSN:1078-1439, 1873-2496, 1873-2496
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Popis
Shrnutí:•Nonmetropolitan community urology practices present important opportunities to increase cancer clinical trial accrual.•Even in communities with available cancer clinical trials, practices have limited awareness of trials because they lack social connections with trial investigators.•Rural-serving urologists were motivated to offer trials because they see trials as extending available treatment options, which is aligned with their professional role.•Practices were receptive to interventions, including external facilitation, to help them offer trials to their patients. Engaging community urologists in referring patients to clinical trials could increase the reach of cancer trials and, ultimately, alleviate cancer disparities. We sought to identify determinants of referring patients to clinical trials among urology practices serving rural communities. We conducted semistructured qualitative interviews based on the Theoretical Domains Framework at nonmetropolitan urology practices located in communities offering urological cancer trials. Participants were asked to consider barriers and strategies that might support engaging their patients in discussions about urological cancer clinical trials and referring them appropriately. Recorded interviews were transcribed and coded using template analysis. Most participants were not aware of available trials and had no experience with trial referral. Overall, participants held positive attitudes toward clinical trials and recognized their potential roles in accrual, but limited local resources reduced opportunities for offering trials. Most participants expressed a need for increased human, financial, and other resources to support this role. Many participants requested information and training to increase their knowledge of clinical trials and confidence in offering them to patients. Participants highlighted the need to build efficient pathways to identify available trials, match eligible patients, and facilitate communication and collaboration with cancer centers for patient follow-up and continuity of care. With adequate logistical and informational support, community urology practices could play an important role in clinical trial accrual, advancing cancer research and increasing treatment options for rural cancer patients. Future studies should explore the effectiveness of strategies to optimize urology practices’ role in clinical trial accrual.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1078-1439
1873-2496
1873-2496
DOI:10.1016/j.urolonc.2019.03.004