February 28, 2019
A new, first-of-its kind project from researchers at The University of Kansas Cancer Center is boosting participation in urological cancer clinical trials by partnering with community urologists.
Clinical trials are research studies that involve people. Clinical trials lead to new ways to prevent, detect or treat disease and are at the heart of all medical advances. Nearly all cancer treatments used today were studied and made available to patients through clinical trials. However, many people don’t take part because they are unaware of clinical trials or they have misconceptions about them.
That’s why KU Cancer Center launched Learn|Inform|Recruit, a program aimed at referring more patients to clinical trial opportunities. Led by principal investigator Shellie Ellis, PhD, a member of KU Cancer Center’s Cancer Control and Population Health research program, the Learn|Inform|Recruit program is initially focusing on urological cancers.
“We focused on a type of cancer that affects many so that our work would have the greatest impact,” Dr. Ellis said. “Approximately 326,000 people in the United States are diagnosed annually with a urological cancer. About 20 percent of all cancers are urologic, which includes cancer of the bladder, kidney, prostate and testicles.”
With funding from the Brown Family Foundation and fellowship training in implementation science from the National Cancer Institute, Learn|Inform|Recruit began by working with urologists and cancer care providers in Kansas to learn more about their unique practices. The program also developed ways to help them refer more of their patients to clinical trials when appropriate.
“Most patients are receiving their urologic care in the community setting, not in an academic medical center. With that in mind, giving the urologists a better idea of how they can be involved in clinical trials is critical,” said J. Brantley Thrasher, MD, FACS, co-investigator and urologist at The University of Kansas Health System.
Dr. Ellis added that it can be challenging for these physicians to access information about clinical trials. Dr. Ellis said it’s important to make the process easier for community providers by helping them strengthen their referral networks. Giving them tools to use in their practice to increase options for patients who are not able to receive treatments in academic settings, like KU Cancer Center, is also important.
Interviews and follow-up conversations with community providers revealed a low awareness of clinical trials. Utilizing KU Cancer Center’s Health Communication Research Shared Resource, the team created special communications tools designed to increase physicians’ awareness of what clinical trials are available, direct them where to refer patients for eligibility screening and share trial information with patients. Researchers developed a website for community doctors as well as a three-part video series to educate patients about trials in a consistent, accurate and convenient way.
“The videos reduce the time the doctors have to spend explaining the clinical trials process and allows them to focus on answering patients’ questions about the disease process and their treatment options, including clinical trials,” explained Mugur Geana, PhD, director of the Health Communication Research Shared Resource.
Preliminary research showed people often didn’t enroll in trials they would have been eligible for because they did not hear about them from their doctors. That indicated a need to raise awareness among doctors on the availability of trials and to encourage them to consider them as a treatment option for their patients. To do that, researchers helped connect oncologists, urologists and available trial sites, as well as provide patient-focused communications pieces like education materials to be displayed in clinic rooms.
Researchers also adapted a provider education module, previously developed by Dr. Geana and colleagues with funding from the Hearst Foundation, to address the specific concerns and needs of urology doctors. The training was offered as part of a continuing medical education module at the 2018 meeting of the South Central Section of the American Urological Association.
The resources and interventions developed through the partnerships in Kansas have been pilot tested in settings throughout Oklahoma and Louisiana. Early results have shown increased trial referrals and improved understanding in both patients and healthcare providers.
“We’re finding the Learn|Inform|Recruit program is effective in boosting people’s opportunities to take part in trials and urologists are reporting they like it as well,” Dr. Ellis said. “We’re now in the process of scaling it up to take it to urologists and oncologists across the nation.”