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Patient attitudes regarding participation in studies of antimicrobial resistance
Pam Tolomeo1, Mary Wheeler, Joshua P Metlay
1Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6021, USA.
Background:
A number of recent studies of antimicrobial resistance have focused on the role of antimicrobial-resistant pathogens that colonize the gastrointestinal tract. However, participation rates have been low in studies that involve fecal sampling. Attitudes toward such studies among potential study participants have not been assessed.
Methods:
We conducted a cross-sectional survey, enrolling 3 groups of inpatients from a large academic center. Group 1 consisted of patients who had previously participated in a cohort study of fluoroquinolone-resistant Escherichia coli, which involved the collection of perirectal swab samples. Group 2 consisted of patients who had previously refused to participate in the study of fluoroquinolone-resistant E. coli. Group 3 consisted of patients who had never been asked to participate in the study of the fluoroquinolone-resistant E. coli. The survey assessed patients' attitudes and beliefs regarding medical research and their willingness to consent to collection of a perirectal swab sample. Response options were recorded on a 5-point Likert scale. The Fisher exact test was used to compare dichotomized responses across study groups.
Results:
A total of 90 patients were surveyed: there were 29 in group 1 and in group 2 and 32 in group 3. Of 90 patients, 31 (35%) believed researchers might run additional tests on collected samples without informing the patient, whereas 25 (27%) believed persons other than the research team might gain access to study results. The belief that a person could get sicker as a result of a having a perirectal swab sample collected was significantly more common among patients who had previously refused to participate in the fluoroquinolone-resistant E. coli study.
Conclusion:
This study highlights important beliefs and attitudes that are associated with the likelihood of participating in studies of antimicrobial resistance. Explicitly addressing these concerns with eligible patients is critical to optimize participation in future studies.
Insights
Low participation in antimicrobial resistance studies involving fecal sampling is a concern. Patients previously refusing sample collection were more worried about potential harm and privacy, impacting future study enrollment.
Area of Science:
- Infectious Diseases
- Medical Research Methodology
- Public Health
Background:
- Antimicrobial resistance (AMR) research often requires gastrointestinal pathogen sampling.
- Low participation rates in fecal sampling studies hinder AMR research progress.
- Patient attitudes towards fecal sampling for AMR studies remain largely unassessed.
Purpose of the Study:
- To assess patient attitudes and beliefs regarding medical research.
- To determine willingness to consent to perirectal swab collection for AMR studies.
- To identify factors influencing participation in fecal sampling research.
Main Methods:
- Cross-sectional survey of 90 inpatients at an academic medical center.
- Survey included patients who previously participated in, refused, or were never asked about an AMR study.
- Assessed attitudes towards research and consent for perirectal swab collection using a 5-point Likert scale.
Main Results:
- 35% of patients believed researchers might conduct unconsented additional tests on samples.
- 27% feared unauthorized access to study results by external parties.
- Patients who previously refused participation were significantly more likely to believe swab collection could cause illness.
Conclusions:
- Patient beliefs about sample misuse and potential harm significantly influence participation in AMR studies.
- Addressing patient concerns regarding privacy and safety is crucial for improving study enrollment.
- Future research should focus on transparent communication to overcome participation barriers.
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