Impact of incorporating APPs on enrollment and engagement in NCI trials at an NCORP site.

Abstract

e23039 Background: Oncology care increasingly relies on multiple team members to deliver high quality care. Clinical trials are integral to advancing the field. Identifying patients and enrolling to clinical trials can be challenging. Patient visits with advanced practice providers (APPs) have increased and the role of APPs continues to evolve. The aim of this project was to allow, enable, and empower APPs to enroll to National Cancer Institute (NCI) sponsored clinical trials at an NCI Community Oncology Research Program (NCORP) site. Methods: In November 2023 HSHS St Vincent Hospital Cancer Centers changed a policy to allow APPs to be the enrolling investigator when allowed by the sponsor. An initial meeting was held to educate APPs on the role they could play in supporting clinical trials and the required research trainings. 15 clinical trials were identified as high priority. APP schedules were screened daily. Regular emails were sent celebrating and congratulating APPs for first enrollments and for consistently high enrollments. Enrolling APPs were recognized for high enrollments at a holiday party in December 2024. In January of 2025, an 15 question survey was sent to 17 APPs in the HSHS St Vincent Hospital Cancer Centers. The survey contained questions from a validated survey on the perspective of APPs about clinical trials. Results: Between 12/1/2023 and 11/30/2024, APPs enrolled a total of 80 patients to NCI funded clinical trials. 11 of the 17 APPs enrolled patients. During this same time, physicians at the same locations enrolled 246 patients to NCI funded trials. APPs enrolled patients on 11 different trials. For those specific trials, physicians enrolled 137. APP enrollments accounted for 25% of total enrollments and accounted for 35% of enrollments to trials that allowed APPs to be the enrolling investigator. Fourteen of the seventeen APPs completed the survey. All 14 eligible APPs completed the electronic survey (three APPs on PTO). All APPs agreed trials are important. 74% felt comfortable discussing clinical trial options. 12 of 14 reported seeing at least 5 patients a week who are enrolled in a clinical trial. While interactions with patients enrolled in clinical trials were abundant, having adequate time to discuss available trials with patients is not. 42% of APPs felt they did not have enough time in a visit to perform this. Having sufficient resources to enroll patients in a clinical trial varied, with 21% of APPs not feeling adequately equipped. Conclusions: Our experience suggests allowing APPs to be the enrolling investigator to clinical trials is feasible, acceptable to APPs, and may lead to increased clinical trial enrollment at a NCORP site. The survey identified potential areas for improvement including increasing the resources available for APPs and optimizing time to discuss with patients. Addressing policies to allow APPs to enroll patients on nearly all NCI sponsored clinical trials should be considered.