Nurse Practitioner/Assistant Researcher University of Hawaii Cancer Center Honolulu, Hawaii, United States
BACKGROUND The mission of the National Cancer Institute (NCI), the federal government's principal agency for cancer research and training is to lead, conduct, and support cancer research across the nation to advance scientific knowledge and help all people live longer, healthier lives. The NCI supports the largest United States network of clinical trials through two programs: National Clinical Trials Network (NCTN) & NCI Community Oncology Research Program (NCORP). Historically, Advanced Practice Providers (APPs) had limited roles in NCI-sponsored research. Over the last two years, APPs have worked with representatives from the NCI and NCI Research Bases to remove barriers and create changes in policy and guidelines to permit APPs to have greater and more meaningful roles in NCI-sponsored trials, consistent with their scope of practice.
METHODS 1. Representatives within the NCI worked with APPs, Nurse Scientists and Physicians from research bases to advocate for changes in the NCI guidelines and polices
2. The SWOG Cancer Nursing Research Sub-Committee and Palliative and End of Life Care Committee launched a five-year APP Engagement project (funded by The Hope Foundation) which included:
a. Conducting a two-hour APP symposium at the Spring 2022 SWOG meeting b. Planning an APP-specific workshop for the Fall 2022 meeting c. Developing an infrastructure and application procedures for a three-year APP task force to identify and implement strategies to remove additional barriers to APP involvement in cancer trials.
3. A working group with representation from the NCI and all of the NCTN/NCORP Research Bases was developed to support the APP initiative and overall practice within the context of NCI-sponsored trials.
RESULTS 1. Post guideline implementation metrics indicate:
a. More than 1000 APPs registered as non-physician investigators (NPIVRs) b. 800 patients were enrolled by APPs to NCI sponsored supportive care and cancer care delivery trials c. 418 sites implemented the policy to allow APPs to sign orders for investigational (IND) agents and 860 NPIVRs were approved for the IND prescribing task d. More than 100 physicians, APPs, nurses, and research professionals participated in the SWOG APP symposium in April 2022. e. The University of Rochester Cancer Center Research Base NCORP research base led an APP-specific symposium in June of 2022 to highlight, facilitate and encourage APP leadership and participation in clinical trials.
IMPLICATIONS FOR PRACTICE 1. Increased APP education and engagement within the NCTN/NCORP Network has the potential to substantially increase accrual and improve conduct of clinical trials. 2. APPs can significantly contribute to protocol development and leadership in NCI sponsored research. 3. APPs’ involvement in clinical research provides an opportunity to expand their clinical practice skills, research expertise, professional development and career satisfaction.
Funding: Supported by NIH/NCI grant award UG1CA189974, and with support from The Hope Foundation for Cancer Research.
.jpg "Christa M. Braun-Inglis, DNP, APRN, FNP-BC, AOCNP® photo")
