Attrition and retention in clinical trials by ethnic origin.
BACKGROUND
Common perceptions exist within the medical community that retention of Hispanics in clinical trials is difficult, albeit little data is available to support this conviction.


METHODS
A total of 541 randomly selected charts from closed clinical trials between 2000 and 2006 were reviewed. Records were from participating institutions in Texas Medical Center, Houston, and targeted diseases of high prevalence, specifically, breast cancer, prostate cancer, and chronic obstructive pulmonary disease (COPD)/asthma.


RESULTS
Overall, 259 participants (48%) completed the trial they were enrolled in (44% whites, 69% Hispanics, 51% blacks; p<.05). Within pediatric trials, whom all were pulmonary patients, retention rates were higher among Hispanics than whites (adjusted odds ratio [OR]=7.49, 95% confidence interval [CI]=1.15-58.03, p=.04). Among adults, patient's ethnicity was unrelated to study completion. All associations were adjusted for possible confounders. Reasons for not completing a trial varied by ethnicity: "patient withdrawing consent" was more common among whites (51.4%) than Hispanics (21.7%) or blacks (26.2%) (p<.05). Hispanics were more inclined to be withdrawn from the trial by the investigator (43.5%) than were whites (24%, p=.04), mostly due to non-compliance with the study protocol.


CONCLUSIONS
Hispanic parents of children with COPD may be more likely to complete a trial than parents of non-Hispanic whites. Among adults, Hispanics had similar completion rates as compared to whites. Culturally sensitive, multi-factorial approaches maybe imperative to increasing patient engagement in clinical trials.
Sangi-Haghpeykar
Haleh
H
Baylor College of Medicine, Houston, TX 77030, United States. halehs@bcm.tmc.edu
Meddaugh
Hannah M
HM
Liu
Hao
H
Grino
Placido
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy; D002648:Child; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D044469:Racial Groups / Q000706:statistics & numerical data; D012737:Sex Factors; D055815:Young Adult