Clinical Trial Participation: A Pilot Study of Patient-Identified Barriers.
Mishellene McKinney, Rose Bell, Cindy Samborski and 5 others
PMID 34800100WHAT IT FOUND
Patients who declined cancer trials worried about placebos, feeling like a guinea pig, and added tests or visits.
Oncology nurses can name these concerns, explain trial phases, and use teach-back during consent.
Key findings
01Placebo worries (52%; n=11) and not wanting to feel like a human guinea pig (43%; n=9) were the top multiple-choice barriers.
02In write-in answers, 47% wanted more supporting evidence to become more interested, and 28% cited extra appointments or tests as reasons they declined.
03Many patients still viewed research positively: 76% (n=16) saw being asked as a positive thing, and 90% (n=19) believed trials help doctors understand and treat cancer.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used a convenience sample at one cancer center, so the views may not match other settings. Only 21 patients completed the survey, and the paper states this was 7% of the eligible patient population. Most participants were non-Hispanic Caucasian (81%; n=17) and had college or higher education (66%; n=14). The sample had few minority patients and a female to male ratio of 2:1. The survey was modified for this setting and was not a validated tool. The qualitative coding used a directed approach, which can lead to confirmation bias. Patients who were deceased, hospitalized, too ill, not interested when approached, or missed were not surveyed. The study did not test whether nurse education or consent communication changes trial enrollment.
Declared interests
The supplied publication types list support from the National Institutes of Health and non-U.S. government sources. The article text does not give an author conflict-of-interest statement or say what the funders did.
The easy way to misread this
Do not read these patient barriers as proof that nurse education will increase trial enrollment. This was a small survey of 21 patients who declined trials at one cancer center, and it did not test an intervention.