Intervention to improve patient-physician communication may improve Black patient participation in clinical trials, study led by Karmanos researcher

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Clinical trials are the pathway to finding new cancer treatments to improve patient outcomes. The National Institutes of Health and other professional organizations require that studies include participants from diverse populations. Historically, Black patients have been underrepresented in clinical trials. This is especially problematic when enrolling Black men in prostate cancer clinical trial studies. Prostate cancer affects more Black men than White men.

A recently published study in Cancer Medicine titled “Addressing multilevel barriers to clinical trial participation among Black and White men with prostate cancer through the PACCT study” looks at some barriers to increasing enrollment of Black men into prostate cancer clinical trials. It also looks at ways to overcome those barriers, including a communication intervention. Susan Eggly, Ph.D., professor in the department of Oncology at the Wayne State University (WSU) School of Medicine and member of the Population Studies and Disparities Research (PSDR) Program at the Barbara Ann Karmanos Cancer Institute, led the study. Black and White men participated in this four-year study at Karmanos Cancer Institute in Detroit and Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore, Maryland.

With help from patients who enrolled in the study, researchers examined two possible barriers to enrolling Black patients in clinical trials. The first was eligibility — many clinical trials have rigorous eligibility requirements. At the completion of the study, Dr. Eggly and her team found only a small percentage of patients were eligible for a clinical trial. Researchers also found that patients with higher incomes were more likely to qualify for a clinical trial than patients with lower incomes.

The second possible barrier was patient-physician communication. There are documented differences in communication between physicians and Black patients versus White patients. The communication intervention used in this study is called a Question Prompt List.

“It is very important for patients to feel empowered to ask questions and get the information they need from their doctors and health care team,” said Dr. Eggly. “This particular question prompt list was designed to help patients prepare for clinic visits by thinking through their questions and concerns about clinical trials.” 

At the end of the four-year study, the research team found that patients who received the Question Prompt List had better communication with their doctor and were more likely to receive an invitation to participate in a clinical trial than patients who did not receive the Question Prompt List.

“It is our responsibility in medical institutions to include a diverse patient population in clinical trials, such as the population we serve at Karmanos. We can do that by expanding eligibility requirements to include more patients and creating trusting patient-physician relationships that allow talking about the importance of clinical trials to find better cancer treatments and help more patients,” concluded Dr. Eggly.

In addition to Dr. Eggly, study co-authors affiliated with Karmanos and WSU included Nicole Senft, Ph.D., Seongho Kim, Ph.D., Elisabeth Heath, M.D., FACP, Hyejeong Jang, MS, Tanina Moore, Ph.D.,  Fatmeh Baidoun, MS, Louis Penner, Ph. D., Terrance Albrecht, Ph.D., Mark Manning, Ph.D., and Lauren Hamel, Ph.D. The authors also included Michael Carducci, M.D., and Dina Lansey, M.S.N., both of Johns Hopkins Sidney Kimmel Comprehensive Cancer Center.

Results and recommendations that come from this study are shared with Karmanos’ 16 locations.

A National Cancer Institute grant supported this study.

Read the study here.

Susan Eggly, Ph.D.

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Oncology - Medical Elisabeth Heath, M.D., FACP