For many years a critical problem for drug and device researchers has been getting physicians and patients to participate in clinical trials. The number and size of these trials has grown rapidly, exacerbating the issue. A number of vendors exist whose primary service is expeditiously identifying physician investigators and recruiting patients. Primarily through judicious use of large financial and other incentives, firms have been able to move clinical trials forward, but still often face delays in critical trials.
The problem is even greater for health services type research which often is looking at care processes, outcomes or doing comparative effectiveness studies. This research is often conducted by academic institutions or foundations, usually on more limited budgets. A new article in the British Medical Journal looks at reasons for physician recruitment difficulties in a study of leg ulcer treatment. (BMJ Article) While the research was being conducted in Germany, which has some unique issues, the barriers to participation are similar to those encountered in other countries. These included lack of time, little financial or other benefit, concern over interference with the ongoing patient relationship and uncertainty over the effects of the results of the study on how the physicians practice. The authors identify several techniques that might make doctors more willing to participate.
As health reform concerns proliferate around the world and there is intense focus especially on health costs, research into how care can be made both more effective and more efficient assumes a critical importance. Understanding how to get physicians not just involved in, but placing a high value on, this research and its results may be a linchpin to creating a better health system.