Strategic physician communication and oncology clinical trials.
OBJECTIVE
Clinical trials are the primary means for determining new, effective treatments for cancer patients, yet the number of patients that accrue is relatively limited. The purpose of this study was to explore the relationship between physician behavior and patient accrual to a clinical trial by videotaping the interaction.


METHODS
Forty-eight patient-physician interactions involving 12 different oncologists were videotaped in several clinics at the H. Lee Moffitt Cancer Center and Research Institute (Tampa, FL). The purpose of each interaction was to present the possibility of a clinical trial to the patient. A coding system, the Moffitt Accrual Analysis System, was developed by the authors to code behaviors that represented both the legal-informational and social influence models of communication behavior. Thirty-two patients agreed to participate in the clinical trial.


RESULTS
Videotaping was found to be a viable, valid, and reliable method for studying the interaction. Physicians who were observed to use both models of influence were found to enroll more patients. Thus, patients were more likely to accrue to the trial when their physician verbally presented items normally included in an informed consent document and when they behaved in a reflective, patient-centered, supportive, and responsive manner. Discussion of benefits, side effects, patient concerns and resources to manage the concerns were all associated with accrual.


CONCLUSIONS
This research has implications for modifying physician behavior and, thus, increasing the numbers of patients accruing to oncology clinical trials.
Albrecht
T L
TL
Medical Interaction Research Group, H. Lee Moffitt Cancer Center and Research Institute, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL 33612, USA. talbrech@com1.med.usf.edu
Blanchard
C
C
Ruckdeschel
J C
JC
Coovert
M
M
Strongbow
R
R
D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D003142:Communication; D003657:Decision Making; D006801:Humans; D007258:Informed Consent; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D012107:Research Design; D012924:Social Conditions; D014741:Video Recording