Factors Leading to Black Patient Disparities in Hematology Trials With Shakira Grant, MBBS

At the recent American Society of Hematology (ASH) Annual Meeting, Shakira J. Grant, MBBS, an Assistant Professor of Medicine at the University of North Carolina at Chapel Hill, sat down with Oncology Data Advisor to discuss her research she presented, If You Don’t Trust Your Doctor That Much…You’d Feel Less Confident Doing a Research Study”: Factors Influencing Black Patient Participation in Hematology Trials.

This podcast episode was recorded live by Oncology Data Advisor and ConveyMED at the 2022 ASH Annual Meeting in New Orleans.

Oncology Data Advisor: Welcome to Oncology Data Advisor. Today we’re here at the ASH Annual Meeting, and I’m here with Dr. Shakira Grant. Thanks so much for being here.

Shakira Grant, MBBS: Thank you so much for having me.

Oncology Data Advisor: Would you like to tell us a little bit about yourself and about what you do?

Dr. Grant: Sure. I am currently an Assistant Professor at the University of North Carolina at Chapel Hill. I am a Geriatric Hematologist and Oncologist and a Clinician Scientist. My research primarily focuses on older adults with multiple myeloma and their caregivers and looking at how factors, such as social disparities, influence their ability to access care and the outcomes for this population.

Oncology Data Advisor: Great. One of your abstracts you presented here was about factors influencing Black patient participation in clinical trials. To start off, would you like to tell us a little bit about the background for this and why you decided to focus on it?

Dr. Grant: One of the reasons that I focused on this particular abstract was really out of knowledge that in clinical trials, there are still these continued barriers of participation for those who identify from racial and ethnic backgrounds that are underrepresented. In particular—thinking about Black patients with multiple myeloma—this represents a group where there are significant disparities in terms of access to care, which ultimately impacts their outcomes and their survival. So, we opted to really try to get a better understanding of the complex drivers that influence patient participation in clinical trials.

Oncology Data Advisor: Great. What did you find in the study? What were the results?

Dr. Grant: In terms of our results, we focused our results on first trying to get a broad understanding, and we identified a few key themes. These were things such as communication between patients and their providers in terms of the language that is used when discussing a trial. For some patients, they felt that this was stigmatizing and often made them feel like they were a guinea pig or being experimented on. And this, again, was a population that all self-identified as Black, in terms of the patients. Another thing that we found was the element of trust or mistrust in the medical health system, as well as within providers and the research enterprise in general. We also identified other barriers such as geographic and financial barriers that also limited access, transportation, and where clinical trials were located.

Oncology Data Advisor: Do you have any next steps for this research about how it could potentially be implicated into practice?

We see this as a potential next step of targeting communication between patients and their physicians by focusing primarily on physician communication, addressing issues such as implicit bias and stereotyping. We see this as the next direction for our research.

Dr. Grant: From our findings, one of the things that we really recognize is that the patient provider, in this case the patient-hematologist relationship, really plays a critical role in whether or not a patient is actually offered the opportunity to participate in a trial. We saw this because our data also identified that there was some bias and stereotyping on the part of the hematologist that led to them making decisions on when to offer trials to participants based on the patient’s race, in this case Black race, or if they were at a socioeconomical disadvantage. We see this as a potential next step of targeting communication between patients and their physicians by focusing primarily on physician communication, addressing issues such as implicit bias and stereotyping. We see this as the next direction for our research.

Oncology Data Advisor: Great. Anything else you’d like to share about either your study or about just your experience at ASH as a whole?

Dr. Grant: Sure. So, I would say, in terms of our study, that we have really taken a deep dive into this topic of the barriers that influence Black patient participation in clinical trials. We did unearth several themes or key topics, and we believe that some of these are quite actionable. For example, things like the language that we use when we’re discussing clinical trials with patients, this could be something that we could easily address in our own practices. We could maybe consider not using “trial” and using “clinical research” or “study participation.”

In terms of other things in general about my experiences at ASH, first, it was really great just being able to present this qualitative work here and to bring the patient voices and the voices of the hematologists to life during our presentations. I just think that overall, the ASH meeting has been a wonderful experience this year, not only about our research, but there’s also just so much fantastic research that is being presented.

Oncology Data Advisor: Awesome. Well, thanks so much for sharing all this.

Dr. Grant: Yes, thank you.

Thank you for listening to this podcast recorded live at the 2022 ASH Annual Meeting by Oncology Data Advisor and ConveyMED. For more expert perspectives on the latest in cancer research and treatment, be sure to subscribe to the podcast at conveymed.io and oncdata.com. Don’t forget to follow us on social media for news, exclusive interviews, and more.

About Dr. Grant

Shakira J. Grant, MBBS, is an Assistant Professor in the Department of Medicine at the University of North Carolina at Chapel Hill. Dr. Grant’s clinical interests revolve around geriatric hematology and oncology, multiple myeloma, patient outcomes, and disparities experienced by older and minority patients that impact their cancer treatment. She uses and lets the geriatrics “4 Ms” principles guide her treatment process: mobility, medicine, matter of mind, and what matters most.

For More Information

Grant S, Baptiste M, Moore M, et al (2022). “If you don’t trust your doctor that much…you’d feel less confident doing a research study”: factors influencing black patient participation in hematology trials. 64th American Society of Hematology Annual Meeting. Abstract 380.

Transcript edited for clarity. Any views expressed above are the speaker’s own and do not necessarily reflect those of Oncology Data Advisor. 


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