Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
Contemp Clin Trials. 2012 Nov;33(6):1143-9. doi: 10.1016/j.cct.2012.08.008. Epub 2012 Aug 19.
The translation of research evidence into practice is facilitated by clinical trials such as those sponsored by the National Cancer Institute's Community Clinical Oncology Program (CCOP) that help disseminate cancer care innovations to community-based physicians and provider organizations. However, CCOP participation involves unsubsidized costs and organizational challenges that raise concerns about sustained provider participation in clinical trials.
This study was designed to improve our understanding of why providers participate in the CCOP in order to inform the decision-making process of administrators, clinicians, organizations, and policy-makers considering CCOP participation.
We conducted a multi-site qualitative study of five provider organizations engaged with the CCOP. We interviewed 41 administrative and clinician key informants, asking about what motivated CCOP participation, and what benefits they associated with involvement. We deductively and inductively analyzed verbatim interview transcripts, and explored themes that emerged.
Interviewees expressed both "altruistic" and "self-interested" motives for CCOP participation. Altruistic reasons included a desire to increase access to clinical trials and feeling an obligation to patients. Self-interested reasons included the desire to enhance reputation, and a need to integrate disparate cancer care activities. Perceived benefits largely matched expressed motives for CCOP participation, and included internal and external benefits to the organization, and quality of care benefits for both patients and participating physicians.
The motives and benefits providers attributed to CCOP participation are consistent with translational research goals, offering evidence that participation can contribute value to providers by expanding access to innovative medical care for patients in need.
临床研究(如美国国立癌症研究所社区临床肿瘤学计划(CCOP)赞助的临床研究)有助于将研究证据转化为实践,这些研究有助于将癌症护理创新传播给社区医生和医疗机构。然而,CCOP 的参与涉及到无补贴的成本和组织方面的挑战,这引起了人们对医疗机构持续参与临床试验的关注。
本研究旨在深入了解医疗机构参与 CCOP 的原因,以便为考虑参与 CCOP 的管理者、临床医生、组织和政策制定者提供决策参考。
我们对参与 CCOP 的五家医疗机构进行了多地点定性研究。我们采访了 41 名行政和临床关键信息提供者,询问他们参与 CCOP 的动机以及与参与相关的益处。我们对逐字记录的访谈记录进行了演绎和归纳分析,并探讨了出现的主题。
受访者表示参与 CCOP 的动机既有“利他主义”的,也有“自身利益”的。利他主义的动机包括增加临床试验机会的愿望,以及对患者的义务感。自身利益的动机包括增强声誉的愿望,以及整合不同癌症护理活动的需求。感知到的益处与参与 CCOP 的动机大致相符,包括对组织的内部和外部益处,以及对患者和参与医生的护理质量益处。
提供者归因于 CCOP 参与的动机和益处与转化研究的目标一致,这表明参与可以通过为有需要的患者扩大获得创新医疗的机会,为提供者带来价值。