Lung I-ACT Improving access and recruitment to clinical trials for lung cancer patients

Background

Lung cancer clinical trials offer lung cancer patients the opportunity to access treatments that are innovative and which might otherwise be unavailable to them.

During the COVID-19 pandemic many lung cancer clinical trials were put on hold, meaning that opportunities for lung cancer patients to access research were rare. Post-pandemic, recruitment to trials has improved, but remains low.

The Lung I-ACT team have published a paper discussing the broader challenges facing lung cancer clinical trial enrolment and why nurses are well placed to support patients in making informed choices about participation.

Findings

The study team sought to identify barriers to participation in lung cancer clinical trials for patients. They conducted a review of the international evidence and identified barriers such as travel and time constraints, financial concerns, geographic disparity, and understaffing in lung cancer departments. A lack of relevant information was also identified, with patients expressing a need for clear and concise messaging regarding clinical trials. The team published the findings of this review in the European Journal of Oncology Nursing.

This information helped the team to conduct focus groups on this topic with lung cancer patients and the healthcare professionals that care for them. They found that many patients were unaware of clinical trial opportunities and would welcome more information about them. Nurses and patients both felt that the discussions they had could be improved if simple, mythbusting information was available to patients throughout their care pathway.

They wanted a printed resource with information about trials to help patients make informed choices about whether clinical trial participation was right for them or not. Both groups stressed the important role that nurses can play in presenting this information because of the close relationship that they have with patients and their coordinating role across the clinical care team.

Tool Development

The review and focus group findings were used to produce a prototype tool which was then discussed with patients and nurses to ensure its practical application.

This helped the team to further develop the tool, and led to the decision to create a patient leaflet that nurses could use to introduce lung cancer patients to clinical trials as a potential option. The design meant that patients could take the information away with them, allowing them to digest and revisit the information when it suited them.

Nurses also said they would benefit from a poster that could be displayed in clinics that would prompt them to use the leaflet, as well as providing hints and tips about how to introduce the topic of clinical trials to patients. They also wanted the poster to contain information about local trials that were open in their area.

Outcomes

With the assistance of a graphic designer, the two elements of the tool have been produced and are now being piloted at participating NHS Trusts.

The Lung I-ACT team will gather survey data and conduct interviews over the next six months to identify whether the resources have been effective in producing a higher quantity and quality of conversations about lung cancer clinical trials.

Academic Publications

Lond, Benjamin et al. (2024). A systematic review of the barriers and facilitators impacting patient enrolment in clinical trials for lung cancer. European Journal of Oncology Nursing, Volume 70. doi: 10.1016/j.ejon.2024.102564.

Dodd, Christopher et al. (2024). Improving patient recruitment to cancer clinical trials: opportunities for cancer nurses. Cancer Nursing Practice. doi: 10.7748/cnp.2024.e1869

Dodd, Christopher et al. (2024). Improving access and recruitment to clinical trials for lung cancer patients: The development of the Lung I-ACT tool (publication forthcoming)

For more information, please contact lung-i-act@brookes.ac.uk