Udrea G, Dumitrescu B, Purcarea M, Balan I, Rezus E, Deculescu D
"Carol Davila" University of Medicine, Bucharest, Romania.
J Med Life. 2009 Apr-Jun;2(2):227-31.
Successful advances in the treatment of rheumatoid arthritis rely on enrolment of patients into clinical trials with novel agents. The aim of this study was to assess the patients' perspectives and motivators to participate in clinical trials.
Consecutive patients with rheumatoid arthritis attending three rheumatology departments in Romania underwent structured questionnaire interview regarding the motivation/possible causes of acceptance or drawbacks to participate in a clinical trial.
A total of 96 patients, mean age 48, 30% men 70% women answered. Response rate was 95%. Previous participation in other clinical trials was 23%. Patients were highly motivated to participate in order to help themselves or other patients and to enhance the knowledge about the disease. Patients were prone to ask for advice about their enrolment in the study from the family and their current physicians, including the general practitioner. The need for supplementary information about the study was felt because they had not dared to ask for the information, although they trusted their current doctor. A high percentage considered payment and free complete blood tests as a stimulus, especially among patients with lower levels of education (p = 0.03, Fisher's ANOVA). Advertising for investigational medical product for purposes of patient recruitment was important for 57%, not only for safety or trust, but also for transparency and as a tool to get information. 73% of the persons agreed to the usefulness of patients association. 26% of them were willing to be actively involved, especially to report and include adverse events in the study settings. 58% were motivated if they knew other patients were consulted. Patients were not motivated because of the adverse events, placebo effect, treatment discontinuation, limited previous experience, availability of alternative therapies and doctor reimbursement for the study.
The current study suggests that awareness of factors (positive and negative) which influence motivation to participate in a clinical trial may help to refine patient's education and to consider new strategies for future trials.
类风湿关节炎治疗的成功进展依赖于患者参与新型药物的临床试验。本研究旨在评估患者参与临床试验的观点及动机。
罗马尼亚三个风湿病科的连续类风湿关节炎患者接受了关于参与临床试验的动机/接受或拒绝的可能原因的结构化问卷调查。
共有96名患者(平均年龄48岁,男性占30%,女性占70%)做出回答。应答率为95%。既往参与过其他临床试验的比例为23%。患者参与的积极性很高,目的是帮助自己或其他患者,并增进对疾病的了解。患者倾向于向家人和包括全科医生在内的现任医生寻求关于参与研究的建议。由于他们不敢询问相关信息,尽管信任现任医生,但仍觉得需要关于该研究的补充信息。高比例的患者认为支付费用和免费进行全血细胞检测是一种激励,尤其是在教育程度较低的患者中(p = 0.03,Fisher方差分析)。用于招募患者的研究用医疗产品广告对57%的患者很重要,这不仅关乎安全性或信任,还涉及透明度以及作为获取信息的工具。73%的人认可患者协会的作用。其中26%的人愿意积极参与,特别是在研究环境中报告并纳入不良事件。如果知道其他患者也被咨询,58%的人会有参与的动力。患者不会因为不良事件、安慰剂效应、治疗中断、既往经验有限、有替代疗法以及医生因研究获得报销而产生参与动力。
当前研究表明,了解影响参与临床试验动机的因素(正面和负面)可能有助于完善患者教育,并为未来试验考虑新策略。