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Incentives and disincentives to participation by clinicians in randomised controlled trials

J M Rendell1, R D Merritt, J R Geddes

  • 1University of Oxford, Psychiatry, Department of Psychiatry, Warneford Hospital, Oxford, UK, OX3 7JX. jennifer.rendell@psych.ox.ac.uk

The Cochrane Database of Systematic Reviews
|April 20, 2007
PubMed
Abstract

Insights

Clinician incentives and disincentives impact patient recruitment in randomized controlled trials (RCTs). Understanding these factors is crucial for improving trial participation and advancing healthcare research.

Area of Science:

  • Clinical Trials Methodology
  • Health Services Research
  • Evidence-Based Medicine

Background:

  • Clinicians and patients require reliable data from randomized controlled trials (RCTs) regarding treatment costs and benefits.
  • Recruitment challenges in RCTs often stem from clinicians not inviting eligible patients to participate.

Purpose of the Study:

  • To evaluate evidence on how disincentives and incentives influence clinicians' invitation of eligible patients to participate in healthcare intervention RCTs.
  • To assess evidence related to clinicians' stated willingness to invite patients to trials.

Main Methods:

  • Searched multiple databases including Cochrane Methodology Register, EMBASE, MEDLINE, CINAHL, PsycINFO, and AMED.
  • Included eleven observational studies exploring the effects of (dis)incentives on clinicians' views and recruitment activities.
  • Extracted data on (dis)incentives and tested associations with recruitment, noting limitations in quality assessment.

Main Results:

  • No RCTs of interventions were identified; eleven observational studies were included.
  • Clinicians acquainted with researchers were less likely to participate (OR 0.4).
  • Recruitment difficulties cited by clinicians included extra work (OR 92.94) and embarrassment (p < 0.0001), with concerns about the doctor-patient relationship acting as a deterrent (p = 0.007).

Conclusions:

  • The influence of various factors on clinician willingness to invite patients to RCTs varies.
  • Trial design and conduct aspects can significantly affect clinicians' willingness to recruit.
  • Further research is necessary to fully understand and address these recruitment barriers.

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