Leveraging advanced practice providers in a clinical research program to provide trial prescreening and counseling increases clinic volume and trial accruals.

Abstract

e13529 Background: Stanford Health Care’s Early Drug Development program (EDD) enables Principal Investigators (PI) throughout the Cancer Center to open early-phase trials that do not fit within established disease-specific programs. To increase patient access to EDD, the Advanced Provider (AP) role was expanded. This abstract will demonstrate the impact of APs on trial access and enrollment in a clinical research program. Methods: AP-led pre-screening practice is intended to increase patient access, and overcome restrictive eligibility criteria, competitive enrollment, and patient-specific barriers. EDD implemented a trial prescreening practice led by two APs who are trained to review molecular profiling, address barriers to enrollment, and provide trial counseling which aligns with the patient's goals of care. New patient visits (NPV) are scheduled with an MD or AP within 2 weeks. PIs maintain oversight through daily "Run-the-Board" meetings, guiding disposition for expedited slot request, to add to robust waitlists, or for AP follow-up to manage interventions and lower barriers to enrollment. Results: Compared to no AP-led prescreening practice, there is +102% of NPV volume and +475% trial accruals. This EDD program became one of the highest enrollers in the institution witin two years. Over time the improvement continues. Since 2021, 2024 EDD NPV are +232%, total visits +367%, and trial accruals +72%. In 2024, EDD APs see 59% of NPV. Conclusions: Leveraging APs in trial pre-screening is a highly effective strategy for increasing patient access and acrrual to early-phase clinical trials. PIs are still providing important supervision and are involved in the disposition plan for patients. Over the past 4 years, this practice increased total and new patient visits. More patients were able to successfully acrrue to early phase trials and receive novel treatments. NPV Volume RPV Volume Visit Volume Trial Accruals Former AP Practice:FY 2019-20 Range: 56-76 Mean: 66 Median: 66 Range: 225-262 Mean: 243.5 Median: 243.5 Range: 281-338 Mean: 309.5 Median: 309.5 Only 2020 data available Range: 8 Mean: 8 Median: 8 Expanded AP Role:FY 2021-24 Range: 123 – 409 Mean: 255.5 Median: 345% Growth: +232% Range: 266 – 1411 Mean: 801.75 Median: 765% Growth: +430% Range: 389 - 1820 Mean: 1057.25 Median: 1010% Growth: +367% Range: 33-57 Mean: 46 Median: 47% Growth: +72% Change since Expanded AP role +102% +241% +475%