Abstract
Clinical trials are vital for evidence-based cancer care. Oncologist engagement in clinical trials has an effect on patient recruitment, which in turn can affect trial success. Identifying barriers to clinical trial participation might enable interventions that could help to increase physician participation. To assess factors affecting physician engagement in oncology trials, a national survey was conducted using the online SurveyMonkey tool (SurveyMonkey, San Mateo, CA, U.S.A.; http://www.surveymonkey.com). Physicians associated with the Canadian Cancer Clinical Trials Network and the Canadian Cancer Trials Group were asked about their specialty, years of experience, barriers to participation, and motivating interventions, which included an open-ended question inviting survey takers to suggest interventions. The survey collected 207 anonymous responses. Respondents were predominantly medical oncologists (46.4%), followed by radiation oncologists (24.6%). Almost 70% of the respondents had more than 10 years of experience. Significant time constraints included extra paperwork (77%), patient education (54%), and extended follow-up or clinic visits (53%). Timing of events within trials was also a barrier to participation (55%). Most respondents favoured clinical work credits (72%), academic credits (67%), a clinical trial alert system (75%), a regular meeting to review trial protocols (65%), and a screening log to aid in patient accrual (67%) as motivational strategies. Suggested interventions included increased support staff, streamlined regulatory burden, and provision of greater funding for trials and easier access to ancillary services. The present study confirms that Canadian oncologists are willing to participate in clinical research, but face multiple barriers to trial participation. Those barriers could be mitigated by the implementation of several interventions identified in the study.
Highlights
Clinical trials are the backbone of modern evidence-based medicine, and trial outcomes inform clinical decisionmaking along the entire spectrum of care
The present study confirms that Canadian oncologists are willing to participate in clinical research, but face multiple barriers to trial participation
The survey had questions concerning six topics: medical specialty, years of experience practicing medicine, factors related to time constraints in clinical trials, barriers to trial participation as an investigator, motivating interventions for participation, and an open-ended question to identify other interventions that might motivate a physician to participate in clinical trials
Summary
Clinical trials are the backbone of modern evidence-based medicine, and trial outcomes inform clinical decisionmaking along the entire spectrum of care. In a cross-sectional study of prematurely terminated clinical trials[1, 905] (12%) of the identified clinical trials were closed early. Of those 905 trials, 619 (68.4%) closed for reasons other than the scientific data related to the trial, with 350 (38.7%) having been closed because of an insufficient accrual rate—the leading cause of trial closure. Another 8.5% of closures were attributable to an unspecified business decision or strategic reasons, and a further 6.4%, to problems with trial administration or conduct, including personnel issues. Identifying barriers to clinical trial participation might enable interventions that could help to increase physician participation
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