Assessing patient perspectives on enrollment in lymphoma clinical trials.

Abstract

Clinical trials drive advances in lymphoma care, yet certain patient groups including socioeconomically disadvantaged, racial/ethnic groups, and women remain underrepresented. Given limited/inconsistent data regarding solutions to improve clinical trial enrollment of these groups, the authors performed a study to assess patient perspectives on barriers to enrollment and define priorities for future interventions. Patients completed surveys developed to assess patient-level factors, barriers to opportunity, attitudes toward participation, and perspectives on interventions. Among 301 participants, non-Hispanic White (NHW) and patients with an income >$100 k/year reported better understanding of clinical trials compared to Hispanic (H) patients and patients with an income <$50 k/year (NHW: 58% vs. H: 40%, p = .015; >$100 k/year: 59.8% vs. <$50 k/year: 38.8%, p = .012). Compared to NHW, H and African American (AA) patients reported more concern regarding visit frequency (NHW: 10%; H: 27%; AA: 23%, p = .005), travel distance (NHW: 14%; H: 34%, p = .010; AA: 31%, p = .013), taking time off work (NHW: 9%; H: 23% p = <.001; AA: 18%, p = .006) and study complexity (NHW: 6%; H: 20%, p = .008; AA: 22%, p = .001). Compared to male patients, female patients more commonly noted that having childcare services (male: 11%, female: 23%, p = .004), flexible appointment times (male: 43%, female: 62%, p = .015), and housing closer to the clinic/hospital (male: 44%, female: 55%, p = .016) as helpful interventions to improve trial participation. Regardless of group, 71% of patients noted that insurance/financial support would be the most helpful facilitator of clinical trial enrollment, and 88% reported their physician's advice would most influence their decision to participate. Data from this study suggest which specific strategies should be prioritized in future implementation studies to improve enrollment in lymphoma clinical trials and achieve disease population representation.