Table 3.
Comparison of clinical trial attitudes and reasons for participation or declination of clinical trial offers as perceived by physicians and staff and reported by cancer patients.
| Physician/staff N = 120 |
Patient N = 150 |
P value | |
|---|---|---|---|
| Clinical trial attitudes | |||
| Positive attitudes | N (%) | N (%) | |
| Being part of a clinical trial helps patients be more in control of their disease and treatment | 65 (57.0) | 104 (69.3) | 0.04 |
| A clinical trial absolutely provides the best treatment available | 24 (20.7) | 90 (60.0) | <0.001 |
| The benefits to patients of being in a clinical trial outweigh any risks or harms | 50 (43.9) | 85 (57.0) | 0.03 |
| Clinical trials are important to the advancement of medical science and clinical cancer care | 115 (99.1) | 148 (98.7) | 0.72 |
| Negative attitudes | |||
| Clinical trials are only offered to people whose disease is hopeless | 10 (8.7) | 41 (27.3) | <0.001 |
| Being in a clinical trial does not help patients personally | 2 (1.8) | 49 (32.9) | <0.001 |
| Patients who enroll in a clinical trial are gambling with their life | 13 (11.3) | 31 (20.8) | 0.04 |
| Doctors only offer clinical trials as a last resort | 14 (12.2) | 35 (23.5) | 0.019 |
| Patients enroll in clinical trials as a last resort | 29 (25.4) | 36 (24.0) | 0.79 |
| Clinical trials are only good for the doctors, not for the patients | 5 (4.3) | 20 (13.4) | 0.013 |
| Reasons to participate in a clinical trial | N = 21 | ||
| To get better treatment | 108 (93.9) | 20 (95.2) | 1.00 |
| Help people in the future | 92 (80.0) | 18 (85.7) | 0.76 |
| To get newest treatment available | 107 (92.2) | 19 (90.5) | 0.68 |
| Doctor recommended it | 100 (84.0) | 19 (90.5) | 0.74 |
| Family wanted it | 56 (50.0) | 7 (33.3) | 0.07 |
| Wanted a better chance at a cure | 94 (80.3) | 20 (95.2) | 0.12 |
| Had no better options | 101 (85.6) | 8 (38.1) | <0.001 |
| Reasons to decline participation in a clinical trial | N = 11 | ||
| Patient-related factors | |||
| Language/cultural barriers | 69 (57.5) | 3 (27.3) | 0.052 |
| Religious reasons | 27 (22.5) | 0 (0.0) | 0.021 |
| Lack of understanding about research trials | 76 (63.3) | 1 (9.1) | 0.001 |
| Lack of interest in clinical trials | 41 (34.2) | 4 (40.0) | 0.71 |
| Psychosocial factors | |||
| Mistrust of the medical system/science/Researchers | 83 (69.2) | 4 (36.4) | 0.043 |
| Feeling physically or emotionally Overwhelmed | 77 (64.2) | 2 (18.2) | 0.003 |
| Logistic factors | |||
| Inconvenience | 71 (59.2) | 3 (27.3) | 0.04 |
| Lack of transportation | 54 (45.0) | 4 (36.4) | 0.75 |
| Family/personal responsibilities | 43 (35.8) | 2 (18.2) | 0.33 |
| Trial-related factors | |||
| Invasive procedures | 50 (41.7) | 1 (9.1) | 0.02 |
| Concerns about toxicity | 72 (60.0) | 2 (18.2) | 0.006 |
| Concerns about randomization or getting a placebo | 85 (70.8) | 3 (27.3) | 0.005 |
| Preference for a proven treatment | 69 (57.5) | 5 (45.5) | 0.53 |
| Financial concerns | |||
| Lack of insurance coverage | 35 (29.2) | 1 (9.1) | 0.29 |
| Additional out-of-pocket costs | 44 (36.7) | 2 (18.2) | 0.33 |