Improving enrollment in cancer clinical trials

To identify successful strategies for clinical trial recruitment.

Survey research.

New Jersey institutions actively recruiting patients for clinical trials.

84 clinical research nurses directly involved with patient recruitment were surveyed, and 50 responded (60% response rate).

Focus group; 34-item, direct mail questionnaire; follow-up telephone interviews; and descriptive statistics.

Strategies for patient recruitment and retention.

Respondents agreed most strongly about the importance of emphasizing to patients that treatment would not be compromised and keeping physicians informed of available protocols. Respondents felt the most effective strategies for increasing public awareness of clinical trials were to highlight participants in past trials and to stress the value of clinical trials through campaigns sponsored by nonprofit organizations. Compared to other respondents, those from cancer centers were significantly less concerned about educating physicians on the value of clinical trials. Focus group and telephone interview participants reported that patient retention in cancer trials was a lesser issue because enrollees tend to be motivated to continue.

Successful recruitment may depend on how a patient is approached about participation, keeping physicians abreast of available trials, and the level of awareness the public or a patient has about clinical research prior to considering it as a treatment option.

Research nurses often are the first to interact with patients considering clinical trial participation and remain involved throughout the trial experience. Depending on the research setting, they are likely to be more informed about available protocols than physicians. Research nurses are in a position to build rapport with and advocate for patients. Strategies to increase enrollment and retention should actively involve these key personnel.