Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
Women Health. 2024 May-Jun;64(5):369-379. doi: 10.1080/03630242.2024.2334700. Epub 2024 May 14.
Although fibromyalgia is a widespread chronic pain condition where 90 percent of patients are women, they are underrepresented in Randomized Clinical Trials (RCTs). We aim to describe the willingness to participate, assess different factors, and explore the impact of sociodemographic and clinical characteristics on perceived barriers to trial participation. This is a cross-sectional survey targeting women with fibromyalgia. Univariate and multivariate logistic regression were performed. Of the 436 women with fibromyalgia, 56 percent were very likely to participate in RCTs. Minorities expressed less interest than non-minorities, while higher pain scores, previous participation, and younger patients reported a higher interest. Barriers significantly associated with a reduced willingness were: the participant's perception (side effects, distance, potential negative impact), the center (reputation), the trial protocol (number of visits, placebo), and trial awareness by their physician. In a multivariate analysis, older age, low education, lower income, and higher pain scores were associated with perceived barriers to RCT participation. Despite the high interest to participate, factors such as side effects, the center's distance, number of visits, placebo treatments, and the institution's reputation must be considered in clinical trials for women with fibromyalgia.
虽然纤维肌痛是一种广泛存在的慢性疼痛疾病,90%的患者为女性,但她们在随机临床试验 (RCT) 中的代表性不足。我们旨在描述参与意愿,评估不同因素,并探讨社会人口学和临床特征对试验参与障碍的感知影响。这是一项针对纤维肌痛女性的横断面调查。进行了单变量和多变量逻辑回归分析。在 436 名纤维肌痛女性中,56%的人非常愿意参加 RCT。少数民族的参与意愿低于非少数民族,而疼痛评分较高、有过既往参与经验和年轻的患者报告的参与意愿较高。与降低参与意愿显著相关的障碍包括:参与者的看法(副作用、距离、潜在的负面影响)、中心(声誉)、试验方案(就诊次数、安慰剂)以及医生对试验的了解程度。在多变量分析中,年龄较大、教育程度较低、收入较低和疼痛评分较高与纤维肌痛患者参加 RCT 的感知障碍相关。尽管有很高的参与意愿,但在针对纤维肌痛女性的临床试验中,必须考虑副作用、中心距离、就诊次数、安慰剂治疗以及机构声誉等因素。