Strategies for improving access to clinical trials by teenagers and young adults with cancer: a qualitative study of health professionals’ views

Ruth Hart, Dorothy Boyle, David A Cameron, Fiona J. Cowie, Larry Hayward, Nicholas B Heaney, Angela B. Jesudason, Julia Lawton

Research output: Contribution to journalArticlepeer-review

Abstract

Objective:
Few teenagers and young adults (TYA) with cancer participate in clinical trials. Lack of opportunity has been identified as a major barrier. We canvassed health professionals’ views on how TYA’s access to trials might be improved.
Methods:
We interviewed 35 professionals with responsibility for delivering or facilitating cancer care and/or clinical trials. We analysed data using a qualitative descriptive approach.
Results:
Interviewees viewed improving TYA’s access to trials as challenging, but possible. They reframed the problem as one of rare disease, and surmised that modifying the organisation, administration, and resourcing of research (and care) might expand opportunities for both TYA and other patients with low volume conditions. Proposals coalesced around four themes: consolidating the pool of patients; streamlining bureaucratic requirements; investing in the research workforce; and promoting pragmatism in trial design.
Conclusion: Accounts suggest there is scope to improve access to trials by TYA with cancer and other patients with rare diseases. Though re-configuring care, research and resource frameworks would present substantial challenges, doing nothing would also have costs. Change will require the support of a range of stakeholders, and agreement as to the best way forward. Further work, such as priority setting exercises, may be necessary to reach a consensus.
Original languageEnglish
Article numbere13408
Number of pages10
JournalEuropean Journal of Cancer Care
DOIs
Publication statusPublished - 31 Jan 2021

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