What motivates physicians to recruit?
As we all know, physicians play a pivotal role in patient recruitment to clinical trials. Unfortunately, we also know that not all physicians are inclined to invite patients to participate in clinical research. You can probably quickly list a number of reasons that this happens --and you likely agree that a complex set of factors influence whether a clinician ultimately offers a particular clinical trials to given patients. Those factors may include interest in research, practical considerations, and a variety of patient factors.
In a Cochrane review article, Rendell et al. identify incentives and disincentives for patient recruitment based on analysis of 11 observational studies.
Among incentives, they list:
- Interest in research and participating in an academic research group,
- Comfort in explaining trials to patients,
- The belief that clinical trials are expensive,
- Available support staff,
- Lower disease status/higher performance status of patients.
The major disincentives include:
- Difficulty in explaining medical uncertainty,
- Stringent trial entry requirements,
- Paperwork burden,
- Advanced patient disease stage,
- Loss of control over patients’ care,
From your experience, what are the strongest motivators for clinician participation in clinical trials and their willingness to recruit patients? What factors have a negative influence? Do you know of any interventions that have focused on increasing incentives and/or decreasing disincentives for recruitment?