P-9 COMET PROJECT – increasing research capability and access to clinical trials for community-based palliative care patients and services

<h3>Background</h3> Despite caring for large numbers of people, the community palliative care sector is underrepresented in clinical research. People receiving community palliative care are frequently older, have significant needs for symptom relief and supportive care, find travel to treatment centres burdensome and are not being served by current systems of clinical trial delivery. However, when given the opportunity many community dwelling patients are highly engaged with clinical trials. Increasing access to clinical trials and research informed care has important outcomes both for the immediate care experiences of patients, and also for the improved care of future patients. <h3>Objectives</h3> COMET (Community Supportive Care Trials Program) Program is a 3-year implementation program that commenced in 2022 to build a sustainable research and clinical trial program for patients and staff in community palliative care services in Victoria. <h3>Methods</h3> The COMET project has adopted a multidimensional implementation approach informed by the RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) implementation framework to build a sustainable research and clinical trial program for patients and staff. Key strategies adopted include: Research capacity building via education, training and provision of resources to community palliative care staff Development of a network of providers involved in clinical research, linking community palliative care services with clinical trials groups, and with other engaged community providers Establishing systems of eligible patient identification using existing data collection and service delivery structures Establishing systems of seamless referral to trial centres Creating accessible clinical trials, including in-home assessments and intervention <h3>Results</h3> To date, the COMET project has successfully engaged with three metropolitan and two regional community palliative care services with plans to build further relationships in 2024. Successful implementation strategies have included: staff education workshops, distribution of resources with resulting increased research activity in the sector evident by patient identification, regular introduction to research by clinical staff and preliminary development of ‘home grown’ research ideas. From a baseline of zero, since implementation of COMET staff have identified 124 potential patients for referral to clinical trials centre. Of these, 63 patients have been referred for consideration of eligibility. In total, through the project 13 patients have been part of a supportive care clinical trial. A clinical trial of acupuncture for advanced cancer pain has been developed and will be run in 2024, it is an accessible trial for patients as some assessments and intervention will be offered in their homes. <h3>Conclusions</h3> COMET is an implementation project still ongoing, that has already demonstrated effective strategies for improving staff and patient engagement with research in the community palliative sector in Victoria. Successful outcomes include increased research capability, patient clinical trial participation and established relationships between service providers. The success of this provides a framework and platform for wider implementation to better meet the unmet needs of the Australian community palliative care population.