Improving Cancer Trial Participation via Web-Based Interventions

Patient awareness and educational support can improve their attitude as well as prepare them to make better informed decisions on clinical trial participation, a new study has found.

Published in the Journal of Clinical Oncology, the study, led by Neal Meropol, MD, of the Case Western Reserve University School of Medicine, was a collaboration across 5 cancer centers, including the Robert Lurie Comprehensive Cancer Center at Northwestern University, Cleveland Clinic Foundation, Fox Chase Cancer Center, and Karmanos Cancer Institute at Wayne State University. Identifying knowledge gaps as one of the barriers of low clinical trial participation by cancer patients, the researchers developed an educational tool called the Preparatory Education About Clinical Trials (PRE-ACT), a Web-based computer program that delivers tailored video educational content to patients so they give serious consideration to clinical trials as a treatment option.

After randomly sorting 1255 cancer patients into a PRE-ACT (623) or control (632) group prior to their visit with an oncologist, the authors found that 21% of patients chose to participate in clinical trials, which is a big contrast to the traditional number of less than 5% trial participants. The control group was exposed to general information on clinical trials developed by the National Cancer Institute. Said Meropol, “Unfortunately, although clinical trials are critical for advancing cancer treatment and ultimately serve as the basis for new standards of care, very few patients participate. We want to close the patient knowledge gap and positively affect their attitudes toward clinical trials.”

PRE-ACT had 3 components:

• Assessment of clinical trials knowledge and attitudinal barriers
• Values assessment with clarification back to patients
• Provision of a video library tailored to address each patient’s barriers

The outcomes evaluated were knowledge and attitude and preparation for decision making about clinical trials. While the authors observed significant improvement in knowledge and attitudes in both groups following PRE-ACT and control interventions, patients in the PRE-ACT group—exposed to educational video programs—had significantly greater increase in knowledge and a decrease in attitudinal barriers compared with patients in the control group. While participants in both groups were more eager to participate in clinical trials, there was a non-significant trend for increased participation in the PRE-ACT group.

“By identifying knowledge gaps and negative attitudes and addressing those before patients meet their doctors to discuss cancer treatment, the patient will be better prepared to make a good decision about whether a clinical trial will be an appropriate option for them. We hope PREACT will result in increased participation in clinical trials by cancer patients through improving knowledge and attitudes and facilitating treatment decision-making,” said Meropol.