Physician- and Patient-based Barriers to NGS Testing

Johns Hopkins Medicine

Status: Enrolling

Conditions: Metastatic Prostate Cancer

Treatments: Other: Provider-level and patient education at end of study; Other: Provider-level and patient-level

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT07209176

IRB00505965

Details and patient eligibility

About

The goal of this study is to improve next-generation sequencing (NGS) testing rates at Johns Hopkins in patients with metastatic prostate cancer. Investigators believe by targeting two barriers, provider-level and patient-level, will improve the testing rate of NGS at Johns Hopkins.

Full description

Next-generation sequencing is recommended by national guidelines in metastatic prostate cancer to inform prognosis, treatment decisions, and eligibility for clinical trials. However, rates are low nationally and around 50-60% at Johns Hopkins. Analysis found that older patients and patients who are not married are less likely to have testing performed. The goals and objectives of this proposed clinical trial are to improve NGS testing rates at Johns Hopkins using a multidisciplinary approach to improve the care of patients living with metastatic prostate cancer and reduce disparities. The hypothesis is that this initiative, which targets two barriers (provider-level and patient-level), will lead to higher rates of NGS ordering at Johns Hopkins.

Enrollment: 256 estimated patients

Sex: Male

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• men diagnosed with metastatic prostate cancer
• seen by Johns Hopkins Medical Oncology as a new patient visit between January 1, 2025 and December 31, 2026

Exclusion criteria

- Patients who have already had NGS testing performed.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

256 participants in 2 patient groups

Provider nudge and patient education at time of enrollment

Experimental group

Description:

The provider level component (implemented for all patients) will be a "nudge" to physicians to order testing via a single email documenting their NGS testing rate relative to the Johns Hopkins top performer and, for those not in the top 20%, a link to the most recent American Society of Clinical Oncology (ASCO) guidelines recommending testing. In addition, there will be a patient component that is a one-page handout of educational material about NGS testing to be sent after their initial visit via email or mail.

Treatment:

Other: Provider-level and patient-level

Provider component and patient education at end of study

Experimental group

Description:

The provider level component (implemented for all patients) will be a "nudge" to physicians to order testing via a single email documenting their NGS testing rate relative to the Johns Hopkins top performer and, for those not in the top 20%, a link to the most recent ASCO guidelines recommending testing. The patient educational material will be provided by email or mail (if no email on file) to those who randomized to this arm.

Treatment:

Other: Provider-level and patient education at end of study