Physicians' preferences for active-controlled versus placebo-controlled trials of new antihypertensive drugs.
OBJECTIVE
To evaluate physicians' preferences for referring patients to, and using information from, active-controlled trials (ACTs) versus placebo-controlled trials (PCTs) of new antihypertensive drugs.


METHODS
Nationwide mailed survey, with telephone contact of nonresponders to assess nonresponse bias.


METHODS
One thousand two hundred primary care physicians randomly selected from the American Medical Association's Master File. Of 1,154 physicians eligible to respond, 651 (56.4%) returned completed questionnaires.


RESULTS
We measured physicians' stated willingness to encourage hypertensive patients to enroll in ACTs and PCTs of new antihypertensive drugs, their views of the relative merits of ACTs versus PCTs, their stated willingness to prescribe new drugs tested in ACTs or PCTs, and their views regarding the overall justifiability of the 2 designs. Physicians were significantly more likely to indicate they would encourage their patients to enroll in ACTs than in PCTs (P <.0001). Physicians thought ACTs provided more valuable information for their practices, were more likely to lead to a public health benefit, offered enrolled patients greater opportunity for personal benefit, and were less likely to expose enrolled patients to unnecessary risks (all P <.0001). Physicians were more likely to prescribe new drugs that had been compared in ACTs (P <.0001), and viewed ACTs as a more justifiable method for testing new antihypertensive drugs (P <.0001). There was no evidence of nonresponse bias for these main results.


CONCLUSIONS
Although PCTs remain the standard method for testing new antihypertensive drugs, physicians strongly prefer ACTs. Using ACTs to test new antihypertensive drugs may enhance the efficiency of patient recruitment and more strongly influence physicians' prescribing practices.
Halpern
Scott D
SD
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, USA. shalpern@med.upenn.edu
Ubel
Peter A
PA
Berlin
Jesse A
JA
Townsend
Raymond R
RR
Asch
David A
DA
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D002986:Clinical Trials as Topic / Q000592:standards*; D003625:Data Collection / Q000379:methods; D004341:Drug Evaluation / Q000379:methods*; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D010919:Placebos / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012306:Risk; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents; D010919:Placebos