What motivates MSers to participate in trials? #MSBlog #MSResearch
"At present several ethical issues regarding trial design are being discussed; for example: (1) is it ethical to still run placebo-controlled trials; (2) is it ethical to use an injectable 1st-line therapy as an active comparator; (3) should we always off subjects a greater chance being on an active therapy compared to placebo. The ethics of placebo have been discussed on this site many times and will become topical again should one of the current progressive trials be positive. I think most MSers want to help with research and in my experience the main reason for not participating in trials is the time commitment required to participate. One of the reasons highlighted below for trial participating is the expectation 'of a greater chance of a cure'. The latter is unrealistic and expectations need to be appropriately managed. Investigator's should be honest about what the trial can deliver; little will be gained by offering false hope. I would be interested in your perspective on this important topic."
Epub: Maida et al. Overcoming recruitment challenges in patients with multiple sclerosis: Results from an Italian survey. Clin Trials. 2014.
BACKGROUND: Recruiting MSers for randomized clinical trials is still extremely difficult. While there has been much research in oncology patients, no previous studies have consistently addressed specific factors affecting the willingness to enroll in multiple sclerosis trials from the MSer's perspective. To this end, we conducted an exploratory study to assess the related factors and to find ways to improve recruitment.
METHODS: This is a single-center, observational study involving 352 consecutive outpatients followed at one site in Italy. MSers completed the Enrollment Problems Questionnaire and Beck Depression Inventory.
RESULTS: Over 50% of the MSers would consider participating in a randomized trial. Willing patients are frequently older, with no children, have a diagnosis of secondary progressive multiple sclerosis, and have already participated in clinical trials. MSers' choices were positively influenced by expectations of having (a) a greater chance of cure, (b) an unavailable drug, (c) a specialist's care, and (d) the chance to contribute to medical research. Willingness was significantly increased by the use of optimistic language and practical/psychological assistance during the decision-making process.
CONCLUSION: MSers' willingness to participate in a randomized trial is mainly related to both altruistic and individual considerations, as well as to a greater chance of specialist/improved care. More effective information flow and an effective, long-standing patient-physician relationship may improve recruitment overall.