Patient Navigators: The Missing Link to Increasing Minority Participation in Cancer Clinical Trials

From the  article on the NIMHD website:

A study conducted by the University of Alabama at Birmingham (UAB) and funded by the National Institute on Minority Health and Health Disparities that promotes the inclusion of minorities in cancer clinical trials has been selected by the American Society of Clinical Oncology to be featured in Clinical Care Advances 2016, an annual review of major advances in clinical cancer research.

The study, led by Mona Fouad, M.D., MPH, director of the UAB Minority Health and Health Disparities Research Center, focuses on the use of patient navigators as a liaison between medical staff and patients, to inform and enroll eligible African American cancer patients into clinical trials.

Dr. Fouad stated this model came as a result of the staggering disparities in clinical cancer research, currently fewer than 10 percent of patients enrolled in cancer clinical trials are minorities.

To achieve accurate results, cancer clinical trials require participation of individuals from all cultural and ethnic backgrounds, however enrollment and retention of minority groups often proves challenging.

“We started with the patient navigation model to assist under-resourced patients in our cancer center,” said Fouad. “We’ve been using patient advocates for the last two decades to promote cancer screening, but then we started thinking, ‘Well, what if they have a positive test?’ ‘How do we link them to the care needed to start treatment?’”

Patient advocates were trained to become patient navigators as a way to steer patients in the right direction to locate resources and enlist the best possible care to treat their cancer diagnosis.

“We were successful in providing this model to help patients comply and complete their cancer care, and when we accomplished that, the compliance rate was as high as 95 percent in low-income populations. So then we thought, why don’t we test this model to see not only if it helps patients to access care, but can it educate them about clinical trials as well,” said Fouad.

Fouad admitted that while many patients were reluctant at first, they came around to the idea once it was explained in detail and resources were provided to make clinical trial involvement easier for them.

“What we found by doing this is that a lot of minority patients are scared about therapeutic trials. They believe that they are experiments, and some were reluctant due to the times they’d have to be available for the trials, so the navigators were able to help with those reservations,” stated Fouad, explaining the navigators were trained to identify resources to aid trial participants.

“Navigators connected patients with social workers and did what they could to make sure all the patient had to focus on was their care and involvement in the clinical trial,” said Fouad.

While it is generally the job of medical staff to offer clinical trials to every eligible patient, the study revealed that protocol is not always followed with minority or lower socioeconomic patients.

“Sometimes, even the physician, if they know there is a patient coming from a rural area or having difficulty traveling, they tend to just not offer them clinical trials because they don’t want to increase the burden on the patient or they think the patient is not going to be a compliant participant, so, unintentionally, they just won’t offer them the trials,” said Fouad.

Read the full article.