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JCO Oncol Pract ; 17(10): 607-614, 2021 10.
Article in English | MEDLINE | ID: covidwho-1060961


Despite efforts to enhance enrollment and the merger of national cooperative groups, < 5% of patients with cancer will enroll into a clinical trial. Additionally, clinical trials are affected by a lack of diversity inclusive of minority patients, rural residents, or low-income individuals. COVID-19 further exacerbated known barriers of reduced physician-patient interaction, physician availability, trial activation and enrollment, financial resources, and capacity for conducting research. Based on the cumulative insight of academic and community clinical researchers, we have created a white paper identifying existing challenges in clinical trial conduct and have provided specific recommendations of sustainable modifications to improve efficiency in the activation and conduct of clinical trials with an overarching goal of providing improved access and care to our patients with cancer.

COVID-19 , Neoplasms , Physicians , Humans , Minority Groups , Neoplasms/therapy , SARS-CoV-2
JCO Oncol Pract ; 17(1): e26-e35, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1024379


PURPOSE: Approximately 20% of caregivers (CGs) live > 1 hour away from the patient and are considered distance caregivers (DCGs) who often report higher distress and anxiety than local CGs. The purpose of this study was to test the effectiveness of an intervention aimed at reducing anxiety and distress in DCGs of patients with cancer. METHODS: This randomized controlled trial enrolled DCGs of patients with all cancer types who were being seen monthly by oncologists in outpatient clinics. There were three arms of the intervention delivered over a 4-month period: arm 1 (a) received 4 monthly videoconference-tailored coaching sessions with an advanced practice nurse or social worker focused on information and support, (b) participated in patient's appointments with the oncologist via videoconference over the 4-month study period, and (c) had access to a website designed for DCGs. Arm 2 did not receive the coaching sessions but received the other two components, and arm 3 received access to the DCG website only. RESULTS: There were 302 DCGs who provided pre- and postintervention data. There were significant anxiety by group (P = .028 and r = 0.16) and distress by group interactions (P = .014 and r = 0.17). Arm 1 had the greatest percentage of DCGs who demonstrated improvement in anxiety (18.6%) and distress (25.2%). CONCLUSION: Coaching and use of videoconference technology (to join the DCG into the patient-oncologist office visit) were effective in reducing both anxiety and distress for DCGs. These components could be considered for local CGs who-with COVID-19-are unable to accompany the patient to oncologist visits.

Anxiety Disorders/psychology , COVID-19/psychology , Caregivers/psychology , Neoplasms/psychology , Adult , Anxiety Disorders/complications , Anxiety Disorders/pathology , Anxiety Disorders/therapy , COVID-19/complications , COVID-19/pathology , COVID-19/therapy , Cost-Benefit Analysis , Female , Humans , Male , Middle Aged , Neoplasms/complications , Neoplasms/pathology , Neoplasms/therapy , Oncologists , Quality of Life , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , Videoconferencing/standards