Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA.
Department of Oncologic Science, University of South Florida, Tampa, Florida, USA.
J Am Geriatr Soc. 2023 Jun;71(6):1917-1922. doi: 10.1111/jgs.18255. Epub 2023 Jan 30.
Older adults are underrepresented in most clinical trials. As the United States observes growth in the number of older adults over time, it will be critical to include them in clinical trials to improve the generalizability of results across age groups. Although clinical trial participation requires clinical trial knowledge, no study has assessed clinical trial knowledge among older adults. Using a national survey, this study aims to identify the prevalence and determinants of clinical trial knowledge among older adults.
We used the 2020 Health Information National Trends Survey for secondary data analysis. We restricted the sample to older adults (aged 65 years and up). Our outcome variable was whether respondents reported having any clinical trial knowledge. We controlled for demographics, social determinants of health, healthcare utilization, and comorbidities through multivariable logistic regression models.
Using a weighted sample of 27,574,958 adults, we estimated that 61.1% of older adults reported having at least some knowledge of clinical trials. After controlling for other factors, those with one to two (OR = 1.80, 95% CI:1.14-2.84) or three to five (OR = 2.93, 95% CI:1.74-4.95) portal visits compared with no portal visits, those with cancer (OR = 1.92, 95% CI:1.22-3.02), and those with depression (OR = 2.27, 95% CI:1.23-4.20) had greater odds of having clinical trial knowledge. Inversely, those with hypertension (OR = 0.62, 95% CI:0.42-0.92) had lower odds of clinical trial knowledge.
Patient portal recruitment may be a supplemental intervention to improve clinical trial knowledge among older adults. Further research on additional interventions for identifying eligible participants is needed to minimize the burden among clinicians amidst other competing demands during clinic visits.
在大多数临床试验中，老年人的代表性不足。随着美国老年人数量的增长，将他们纳入临床试验对于提高各年龄段结果的普遍性至关重要。尽管临床试验参与需要临床试验知识，但尚无研究评估老年人的临床试验知识。本研究使用全国性调查，旨在确定老年人临床试验知识的流行率和决定因素。
我们使用 2020 年健康信息国家趋势调查进行二次数据分析。我们将样本限制在 65 岁及以上的老年人。我们的结局变量是受访者是否报告具有任何临床试验知识。我们通过多变量逻辑回归模型控制了人口统计学、健康的社会决定因素、医疗保健利用和合并症。
使用加权样本 27574958 名成年人，我们估计 61.1%的老年人报告至少具有一些临床试验知识。在控制其他因素后，与没有门户网站访问的老年人相比，有一到两次（OR=1.80，95%CI：1.14-2.84）或三到五次（OR=2.93，95%CI：1.74-4.95）门户网站访问的老年人、患有癌症（OR=1.92，95%CI：1.22-3.02）和患有抑郁症（OR=2.27，95%CI：1.23-4.20）的老年人更有可能具有临床试验知识。相反，患有高血压（OR=0.62，95%CI：0.42-0.92）的老年人具有较低的临床试验知识的可能性。
患者门户招募可能是改善老年人临床试验知识的补充干预措施。需要进一步研究其他干预措施，以确定合格参与者，以尽量减少临床医生在就诊期间面临的其他竞争需求的负担。
