Assessing patient perspectives on enrollment in lymphoma clinical trials

BACKGROUND: 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. METHODS: Patients completed surveys developed to assess patient-level factors, barriers to opportunity, attitudes toward participation, and perspectives on interventions. RESULTS: 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. CONCLUSION: 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.