In the second installment of the Clinical Accelerator “Barriers to recruitment” blog series, I will discuss the obstacles faced by clinicians when recruiting patients for clinical trials and suggest ways in which these can be overcome.

Clinical trials rely on healthcare professionals for the successful recruitment of patients, but lack of time can pose a huge barrier for clinicians. The requirement of clinicians to see large numbers of patients in a short space of time makes identifying appropriate patients for clinical trials a challenge.

Severe time pressures on healthcare professionals also make keeping up to date with the latest clinical trials difficult, adding a further hindrance to their ability to recruit patients. Even when a clinician manages to remain abreast of the latest trials, it can be hard to remember the specific enrollment criteria whilst in the process of caring for patients.

Another barrier to recruitment is fear amongst healthcare professionals: fear that patients might not receive the best treatment possible, or that physicians might lose their patients if they recommend participation in a clinical trial.

So how can the process be made easier for clinicians? One solution is for practices to employ a dedicated research nurse, clinical trials coordinator, or a clinical trials patient navigator whose role is to stay up to date with the latest trials.  He or she can advise physicians about those trials that are most relevant for their patients, and, just as importantly, talk with patients about what they involve.

Collaboration between researchers, nurses and physicians is also of vital importance to the success of clinical trial recruitment. Effective communication between these individuals will increase their knowledge and awareness of clinical trials and help to address any concerns. In a recent article in OncLive, a panel of clinical research experts and healthcare professionals noted that regular meetings between researchers and physicians are critical, providing a forum discuss the latest trials and any concerns or queries they might have.

Another key element to fostering successful collaborations between clinical trial practises and healthcare professionals is good communication and setting achievable targets. For example, regular communications from research organisation, such as newsletters listing current and ongoing trials, were noted as being particularly helpful for clinicians and nurses.

Practices could also consider setting individual or institution-wide goals for recruiting patients to clincial trials. Some experts have even suggested tying continuing medical education credits with trial recruitment.

Finally, focusing on the success stories and providing positive feedback is just as important, both for physicians and patients.

It is possible for well-organized clinical trial sites to implement all of these strategies. However, there is also a considerable place for patient enrolment organizations to assist the physicians with designing, planning and implementing all these or other applicable approaches. Busy investigators can outsource some of these tasks to professional patient enrolment managers or implement patient enrolment strategies as a collaborative effort with a patient enrolment organization.

In OncLive’s article, Sue Childress, Director of nursing at the Huntsman Cancer Institute at the University of Utah described her experiences with trial recruitment. “When we initially started phase I trials, the nurses were concerned that patients may not receive the best treatment possible,” she said. “After listening to their concerns and addressing them, now what I hear is that they are proud to work in a place that offers these trials. The patients don’t have to travel to Chicago or San Francisco.”

Her approach demonstrates the success that can be achieved in collaborations between clinical trials practises and healthcare professionals, with the appropriate support.

At Clinical Accelerator, we’re utilizing or encouraging all of these and many other general and project-specific strategies with our partner clinical sites. We’re firm believers that, with the correct communication and feedback mechanisms, the barriers to patient recruitment experienced by clinicians can be vastly reduced.

References

Tackling Patient Recruitment Challenges in Clinical Trials – http://www.onclive.com/publications/oncology-live/2014/march-2014/tackling-patient-recruitment-challenges-in-clinical-trials/