INNV-06. FACTORS INFLUENCING RECEPTIVITY TO CLINICAL RESEARCH IN AN URBAN NEURO-ONCOLOGY PRACTICE

Abstract

Fewer than 3% of cancer patients participate in clinical trials. Nervous system involvement creates additional challenges to accrual including reduced capacity for informed decision‐making and increased reliance on caregivers. To better identify barriers to enrollment, we designed and tested surveys to elicit patient perceptions about research and collect data on potential factors influencing receptivity to involvement. A 20‐item survey, later expanded to 44, was provided to patients at the time of their first outpatient visit. The survey was voluntary and administered as part of a QI initiative conducted by Columbia's Division of Neuro‐oncology over the course of 54 clinical practice days. Questions assessed demographics (race/ethnicity, education, language, employment, marital status); social support; travel burden; medical information and decision‐making preferences; receptivity to participation in research and rationales for refusal. Approximately 200 patients received the questionnaire; 139 (70%) responded. Median age was 55 (range: 17‐85). There were 70 (50%) men; 55 (40%) self‐identified as non‐Hispanic White; 20 (14%) were non‐fluent in English. Diagnoses included high grade glioma (29%), CNS metastases (24%), meningioma (13%), primary CNS lymphoma (3%) and low‐grade glioma (5%). Of 121 responders, 37 (31%) were unwilling to participate in research a priori. The percentage increased to 42% if randomization was involved, 61% if placebo‐controlled. Logistic regression was performed to assess the impact of factors on respondents' willingness to participate in clinical research. Disease severity was the strongest predictor of receptivity (OR: 3.4; CI 1.3‐8.8), but full‐time employment (OR: 3.2; CI 1.2‐8.5) and the presence of caregiver support (OR: 5.4; CI: 1.2‐24.4) were also significant. While further research is needed to better understand barriers to trial enrollment, caregiver influence remains largely unexplored. To that end, Columbia is undertaking a pilot to assess the short and long‐term impacts of high grade glioma on caregivers and their role in clinical decision making.