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Table 2 Barriers to cancer control trial accrual at institutions

From: Facilitating accrual to cancer control and supportive care trials: the clinical research associate perspective

Themes and sub-themes (number of times mentioned) Example quotations
Staff presence and dynamics (29)
Insufficient staff (16) "No CRA manpower to dedicate to data collection and study coordination."
Insufficient time (7) "The most pressing problem is time - not enough time to get all of the protocols through the IRB and not enough to complete data."
"Sometimes identified patients end up not going on study due to the lack of time for consenting by staff physicians/fellows/NPs in a timely manner."
Lack of communication (4) "(Need) good communication between the research team and the clinical team."
Lack of awareness (2) "Lack of knowledge by the clinical staff of available and currently open COG studies."
Logistics including adequate numbers of eligible patients (26)
Eligibility criteria too restrictive (13) "Apart from inclusion/exclusion, sometimes the need to start within a certain period."
Regulatory barriers to trial activation (6) "Getting trials open - bureaucratic hoops."
Inability to identify eligible patients (4) "(…) it is difficult for a CRC to keep on top of all potentially eligible patients,"
Overwhelmed patients/families (3) "Physicians struggle with when to approach (…) when MDs choose to wait, the studies are often forgotten."
Interests and priorities (13)
CCL not a priority (8) "(CCL is) at the bottom of our priority list amongst all other front line treatment studies."
"Investigators focusing all their efforts on the treatment studies."
Lack of family interest (3) "Feeling like they will be taking another medication that is really not required."
Perceived negative effects of study medications (2) "Some physicians may be biased about perceived effects/side effects of the study."
Resources (6)
Lack of adequate resources (4) "Studies that have research funded procedures (are easier)."
Low reimbursement (2) "Low reimbursement."
  1. Abbreviation: CCL, Cancer Control and Supportive Care; COG, Children’s Oncology Group; CRA, Clinical research associate; IRB, Institutional review board; NP, Nurse practitioner; CRC, Clinical research coordinator; MD, Medical doctor.