title: Paying clinicians to join clinical trials: a review of guidelines and interview study of trialists.
abstract: BACKGROUND
  The motivations of clinicians to participate in clinical trials have been little studied. This project explored the potential role of payment for participation in publicly funded clinical trials in the UK. The aims were to review relevant guidelines and to collate and analyse views of clinical trialists on the role of payments and other factors that motivated clinicians to join clinical trials.
  
  
  METHODS
  Review of guidelines governing payments to clinicians for recruitment to trials. Semi-structured interviews with a range of NHS clinical trial leaders, analysed using qualitative methods.
  
  
  RESULTS
  While UK guidelines had little to say specifically on payments linked to recruitment, all payments have become highly regulated and increasingly transparent. Interview participants believed that expenses arising from research should be covered. Payments in excess of expenses were seen as likely to increase participation but with the risk of reducing quality. Motivations such as interest in the topic, the scope for patients to benefit and intellectual curiosity were considered more important. Barriers to involvement included bureaucracy and lack of time.
  
  
  CONCLUSIONS
  Limited scope exists for paying clinicians over-and-above the cost of their time to be involved in research. Most trialists favour full payment of all expenses related to research.
  
  
  CONCLUSIONS
  Payment of clinicians beyond expenses is perceived to be a less important motivating factor than researching important, salient questions, and facilitating research by reducing bureaucracy and delay.
authors.affiliation: Wessex Institute for Health R&D, School of Medicine, University of Southampton, Southampton, UK. raftery@soton.ac.uk
authors.forename: James
authors.initials: J
authors.lastname: Raftery
authors.forename: Christine
authors.initials: C
authors.lastname: Kerr
authors.forename: Sheila
authors.initials: S
authors.lastname: Hawker
authors.forename: John
authors.initials: J
authors.lastname: Powell
mesh_terms: D000533:Altruism; D001291:Attitude of Health Personnel; D002986:Clinical Trials as Topic / Q000191:economics* / Q000941:ethics; D016265:Conflict of Interest; D026690:Ethics, Clinical; D005380:Financing, Government; D017408:Guidelines as Topic; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D009042:Motivation; D009313:National Health Programs / Q000191:economics*; D018579:Patient Selection; D010820:Physicians / Q000191:economics / Q000523:psychology; D012109:Research Support as Topic / Q000941:ethics; D006113:United Kingdom