title: Barriers to clinical trial participation as perceived by oncologists and patients.
abstract: Although clinical trial research is required for the development of improved treatment strategies, very few cancer patients participate in these studies. The purpose of this study was to describe psychosocial barriers to clinical trial participation among oncologists and their cancer patients. A survey was distributed to all medical oncologists in Pennsylvania and a subset of their patients. Relevant background information and assessment of practical and psychosocial barriers to clinical trial participation were assessed. Among 137 oncologists and 170 patients who completed the surveys, 84% of patients were aware of clinical trials, and oncologists and patients generally agreed that clinical trials are important to improving cancer treatment. However, oncologists and patients were more likely to consider clinical trials in advanced or refractory disease. When considering 7 potential barriers to clinical trials, random assignment and fear of receiving a placebo were ranked highly by both patients and oncologists. Patients identified fear of side effects as the greatest barrier to clinical trial participation, whereas oncologists ranked this psychosocial barrier as least important to their patients. Overall, the study found that although oncologists and patients are aware of clinical trials and have favorable attitudes toward them, psychosocial barriers exist for patients that may impact participation in clinical trials. Furthermore, important discrepancies exist between the perceptions of oncologists and those of patients regarding what the psychosocial barriers are. We concluded that characterizing oncologist and patient perceived barriers can help improve communication and decision making about clinical trials, such that participation may be optimized.
authors.affiliation: Divisions of Medical Science, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. Neal.Meropol@fccc.edu
authors.forename: Neal J
authors.initials: NJ
authors.lastname: Meropol
authors.forename: Joanne S
authors.initials: JS
authors.lastname: Buzaglo
authors.forename: Jennifer
authors.initials: J
authors.lastname: Millard
authors.forename: Nevena
authors.initials: N
authors.lastname: Damjanov
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Miller
authors.forename: Caroline
authors.initials: C
authors.lastname: Ridgway
authors.forename: Eric A
authors.initials: EA
authors.lastname: Ross
authors.forename: John D
authors.initials: JD
authors.lastname: Sprandio
authors.forename: Perry
authors.initials: P
authors.lastname: Watts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D002986:Clinical Trials as Topic; D003144:Communication Barriers; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D018579:Patient Selection; D010414:Pennsylvania; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires