title: So different, yet so similar: meta-analysis and policy modeling of willingness to participate in clinical trials among Brazilians and Indians.
abstract: BACKGROUND
  With the global expansion of clinical trials and the expectations of the rise of the emerging economies known as BRICs (Brazil, Russia, India and China), the understanding of factors that affect the willingness to participate in clinical trials of patients from those countries assumes a central role in the future of health research.
  
  
  METHODS
  We conducted a systematic review and meta-analysis (SRMA) of willingness to participate in clinical trials among Brazilian patients and then we compared it with Indian patients (with results of another SRMA previously conducted by our group) through a system dynamics model.
  
  
  RESULTS
  Five studies were included in the SRMA of Brazilian patients. Our main findings are 1) the major motivation for Brazilian patients to participate in clinical trials is altruism, 2) monetary reimbursement is the least important factor motivating Brazilian patients, 3) the major barrier for Brazilian patients to not participate in clinical trials is the fear of side effects, and 4) Brazilian patients are more likely willing to participate in clinical trials than Indians.
  
  
  CONCLUSIONS
  Our study provides important insights for investigators and sponsors for planning trials in Brazil (and India) in the future. Ignoring these results may lead to unnecessary fund/time spending. More studies are needed to validate our results and for better understanding of this poorly studied theme.
authors.affiliation: Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Paraná, Brazil.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Zammar
authors.forename: Henrique
authors.initials: H
authors.lastname: Meister
authors.forename: Jatin
authors.initials: J
authors.lastname: Shah
authors.forename: Amruta
authors.initials: A
authors.lastname: Phadtare
authors.forename: Luciana
authors.initials: L
authors.lastname: Cofiel
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pietrobon
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000533:Altruism; D001938:Brazil; D002986:Clinical Trials as Topic; D003466:Cultural Characteristics; D005260:Female; D015658:HIV Infections / Q000628:therapy; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010358:Patient Participation; D018579:Patient Selection