title: Cardiology clinical trial participation in community-based healthcare systems: obstacles and opportunities.
abstract: BACKGROUND
  The objective of our study was to examine cardiologists' and organizational leaders' interest in clinical trial participation and perceived barriers and facilitators to participation within ten diverse non-profit healthcare delivery systems. Trials play a pivotal role in advancing knowledge about the safety and efficacy of cardiovascular interventions and tests. Although cardiovascular trials successfully enroll patients, recruitment challenges persist. Community-based health systems could be an important source of participants and investigators, but little is known about community cardiologists' experiences with trials.
  
  
  METHODS
  We interviewed 25 cardiology and administrative leaders and mailed questionnaires to all 280 cardiologists at 10 U.S. healthcare organizations.
  
  
  RESULTS
  The survey received a 73% response rate. While 60% of respondents had not participated in any trials in the past year, nearly 75% wanted greater participation. Cardiologists reported positive attitudes toward trial participation; more than half agreed that trials were their first choice of therapy for patients, if available. Almost all leaders described their organizations as valuing research but not necessarily trials. Major barriers to participation were lack of physician time and insufficient skilled research nurses.
  
  
  CONCLUSIONS
  Cardiologists have considerable interest in trial participation. Major obstacles to increased participation are lack of time and effective infrastructure to support trials. These results suggest that community-based health systems are a rich source for cardiovascular research but additional funding and infrastructure are needed to leverage this resource.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
authors.forename: Carol P
authors.initials: CP
authors.lastname: Somkin
authors.forename: Andrea
authors.initials: A
authors.lastname: Altschuler
authors.forename: Lynn
authors.initials: L
authors.lastname: Ackerson
authors.forename: Dennis
authors.initials: D
authors.lastname: Tolsma
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Rolnick
authors.forename: Robert
authors.initials: R
authors.lastname: Yood
authors.forename: W Douglas
authors.initials: WD
authors.lastname: Weaver
authors.forename: Ann
authors.initials: A
authors.lastname: Von Worley
authors.forename: Mark
authors.initials: M
authors.lastname: Hornbrook
authors.forename: David J
authors.initials: DJ
authors.lastname: Magid
authors.forename: Alan S
authors.initials: AS
authors.lastname: Go
mesh_terms: D000328:Adult; D035843:Biomedical Research; D002309:Cardiology; D002986:Clinical Trials as Topic; D003153:Community Health Services / Q000458:organization & administration*; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012107:Research Design; D011795:Surveys and Questionnaires; D014481:United States