Barriers and facilitators to implementing the clinical trial navigator program: A qualitative analysis.

Abstract

e23198 Background: The Clinical Trials Navigator (CTN) Program was launched in 2019 to increase enrollment in cancer clinical trials. It is free for all Canadians, and over 550 people have now used the Program. This study assesses the perspectives of people with cancer regarding the implementation of clinical trial navigation in Canada. Methods: People with cancer and their caregivers (n = 21) were recruited from across Canada to participate in a 30-60 minute semi-structured interview. Based on the Consolidated Framework for Implementation Research (CFIR) domains, we assessed the benefits, needs, facilitators, and access to clinical trial navigation in Canada. Thematic analyses were performed by two independent researchers in duplicate using inductive and deductive coding. Results: 10 Interviewees had contacted the CTN Program (Pre-CTN) but had not yet received navigation for clinical trials, 10 had never contacted the CTN Program (Non-CTN) and 1 completed the CTN Program (Post-CTN). The participants valued early and direct access to information about clinical trials and perceived the CTN Program as a unique and trustworthy resource because it was free and created by Canadians. CTN 9: “I know you're Canadian. So that matters to me because I'm also Canadian” CTN 5: “Yeah, it's ethical. It's transparent and free. Free is a good thing. Mostly what I'm looking for where I can get a straight answer for a straight question.” The CTN Program provided a sense of relief and control for people with cancer and their caregivers during their cancer journey. CTN 5: “It’s really important for people who are going through this kind of psychological and emotional whirlwind to know that there is that avenue available in Canada Participants valued finding a clinical trial when needed. Post-CTN 1 “Ohhhhh yes, because I'm going to know that I have options when I need them ...Good to know that I have something to fall back on...it certainly made a difference.” There were differences among oncologists in the support of identifying clinical trials, and the CTN Program was perceived as an important solution to reducing this variability. CTN 9 “And my oncologist is very well informed. So I don't know, my experience has been that. [Clinical trials] were mentioned to me. I don't know if everyone has that experience.” CTN 2 “And I've been asking my previous oncologist on how I can get on it, and I wasn't really helped, so I went out because ...my treatment options are limited and or there are none no more.” Conclusions: Our results illustrate the gaps in the Canadian clinical trial ecosystem and emphasize the value of the CTN Program to Canadians with cancer. The CTN Program addresses issues such as the timeliness and legitimacy of clinical trials information, increases patient sense of control and alleviates the burden of unexplored options.