Canadian researchers led by physicians from Queen’s University, Ontario, conducted a study probing into the barriers physicians face to successfully participate in clinical trials.
The backbone of modern evidence-based medicine, clinical trials inform clinical decision-making along for the entire spectrum of care. It is not simple or straightforward for physicians to transition into conducting clinical trials—they are complex and expensive—and presuppose a significant investment in time, knowledge, capacity and what this author calls “vocational certainty.” Clinical trials necessitate the coordination and collaboration of a number of entities from health care providers, patients, administrators and government and often industry sponsors. Material barriers to any one of these groups represents a real detriment to any successful clinical trials program.
A Study of the Barriers to Physician Participation in Clinical Trials
A group of Canadian researchers addressed this topic with cross-sectional study of prematurely terminated clinical trials. In this study focusing on physician barriers in clinical trials participation, they found that out of 905 (12%) of the identified clinical trials were closed early. Of those 905 studies, 619 (68.4%) closed for reasons other than the scientific data related to the trial, with 350 (38.7%) having been closed because of an insufficient accrual rate—the leading cause of closure.
Moreover, 8.5% of clinical trial closures were attributable to an unspecified business decision or strategic reasons, and a further 6.4% to problems with trial administration or conduct, including personnel issues. These proportions compare with 193 closures (21%) related to scientific data, 3.8% to funding, and 5.6% to results of other trials or to changes in the standard of care.
Physicians (Investigator) are Key
The Canadian team introduces the important reality that physicians are a key human resource conducting clinical trials. It is their levels of engagement, buy-in, commitment, capacity and financial wherewithal that can make or break an investigational sites success in a clinical trial.
TrialSite News provides the study teams snapshot summary of results. For a more detailed read follow the link to the source study. The survey collected 207 anonymous responses. Respondents were predominantly medical oncologists (46.4%), followed by radiation oncologists (24.6%). Almost 70% of the respondents had more than 10 years of experience. Significant time constraints included extra paperwork (77%), patient education (54%), and extended follow-up or clinic visits (53%). Timing of events within trials was also a barrier to participation (55%). Most respondents favored clinical work credits (72%), academic credits (67%), a clinical trial alert system (75%), a regular meeting to review trial protocols (65%), and a screening log to aid in patient accrual (67%) as motivational strategies. Suggested interventions included increased support staff, streamlined regulatory burden, and provision of greater funding for trials and easier access to ancillary services.
The study team confirmed that Canadian oncologists are willing to participate in clinical research, but face multiple barriers to trial participation. Those barriers could be mitigated by the implementation of several interventions identified in the study. TrialSite News provides a link to the study for those interested in a deeper dive.
Aamer Mahmud, MD, Department of Oncology, Queen’s University Cancer Centre of Southeastern Ontario
Osbert Zalay, MD, PhD, Department of Oncology, Queen’s University Cancer Centre of Southeastern Ontario
A Springer, BSc, Department of Health Sciences, Queen’s University, Kingston, ON
K Arts, BSN, MSN, Canadian Cancer Clinical Trials Network, Toronto, ON.Source: PMC