Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

What Factors Influence Whether Clinicians Discuss Cancer Clinical Trials with Rural Residents (125792)

Narelle McPhee 1 2 , Michael Leach 2 , Samuel Harris 1 , Claire Nightingale 3 , Eva Segelov 4 , Eli Ristevski 5
  1. Bendigo Cancer Centre, Bendigo Health, Bendigo, Victoria, Australia
  2. School Rural Health , Monash University, Bendigo, Victoria, Australia
  3. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  4. Department of Clinical Research, University of Bern and the University Cancer Centre Inselspital, Bern, Switzerland
  5. School Rural Health, Monash University, Warragul, Victoria, Australia

Background

Despite endorsements from cancer control agencies, participation in cancer clinical trials (CCTs) remains lower among rural residents than metropolitan residents. Yet research on how clinicians discuss CCTs with patients is lacking. We aimed to explore the factors influencing whether clinicians discuss CCTs with rural cancer patients.

Methods

A grounded theory study was undertaken. Semi-structured interviews were conducted with participants from two professional groups: a medically based group, including medical oncologists and haematologists, and a non-medically based group, consisting of CCT coordinators and managers. Using purposive and theoretical sampling, participants were recruited from rural and metropolitan health services in Victoria, Australia. Interviews were conducted via video conferencing and transcribed verbatim. A three-step coding process and concurrent data collection and analysis were implemented to develop a theory explaining the phenomenon studied.

Results

Semi-structured interviews were conducted with 29 participants: 21 (72%) medically based and 8 (28%) non-medically based. Participants worked across metropolitan (n =8; 28%), rural (n = 17; 57%) and combination of metropolitan and rural (n=4; 14%) areas.  Data analysis showed two pathways: (1) clinicians have clinical trials at the forefront of their minds, prompting clinical trial discussions with rural cancer patients, or (2) clinical trials are not at the forefront of clinicians' minds, but some conditions prompt clinical trial discussions with rural cancer patients. The value of a CCT discussion is conditional upon the dynamic interplay between clinician capacity, institutional support, perceived patient capacity, and trial characteristics. These capacity domains must align to create optimal conditions for the initiation of clinical trial discussions by treating clinicians. 

Conclusions

It is necessary to establish a standardised approach to CCT discussion that is not clinician-dependent. This uniformity would ensure all cancer patients can consider CCT participation, regardless of where they reside or seek care.