Patient Enrollment onto Clinical Trials: the Role of Physician Knowledge

J Canc Educ (2014) 29:7479 DOI 10.1007/s13187-013-0548-z

Patient Enrollment onto Clinical Trials: the Role of Physician Knowledge

Justin R. Gregg & Leora Horn & Mario A. Davidson & Jill Gilbert

Published online: 28 October 2013# Springer Science+Business Media New York 2013

Abstract Sixty-six attending physicians at academic medical centers completed a 43-question self-assessment evaluating communication skills, comfort with clinical trial enrollment, and knowledge of patient-related barriers to enrollment on clinical trials. Responses and demographic information were analyzed for trends and for association with estimated trial enrollment. Physician-described enrollment of patients onto trials varied widely, with estimated enrollment varying from less than 5 patients to well over 125 enrolled during the previous year. Participants perceived themselves to have excellent communication skills and were comfortable with the trial enrollment process, though did not consistently identify patient-related barriers to enrollment. Physician knowledge of clinical trials currently enrolling within their field was associated with increased patient enrollment on study (p =0.03). Academic physicians expressed confidence in their skills related to clinical trial enrollment despite less than ideal reported enrollment. Knowledge of clinical trials currently enrolling within a physicians specialty was associated with estimated patient enrollment, and may represent a correctable barrier to trial enrollment.

Keywords Clinical Trials . Barriers . Self-Assessment . Knowledge . Enrollment

Introduction

Enrollment of patients onto clinical trials is essential to advance the field of medicine; however, many barriers exist related to entry of adult patients onto clinical trials and successful completion of studies [1, 2]. Low patient enrollment into clinical trials leads to delays in trial completion and treatment advances as well as premature trial termination and wasted resources [3, 4]. Getz and colleagues estimated that over 90 % of trials are delayed due to problems with enrollment [5]. Known barriers to clinical trial enrollment include trial availability for individual patients or disease processes, patient-related factors, and physician-related factors [2, 6]. While trial availability relates to a lack of opportunity at a systemic level, patient-related factors are broad and include concerns about trial costs, transportation issues, and fears related to receiving a placebo or suffering from unknown side effects [7, 8]. Notably, underrepresented minorities have particularly low enrollment onto clinical trials and studies have shown that these patients may be particularly affected by...