Factors influencing physician referrals of patients to clinical trials

Initial trials in the NIH Parkinson's disease (PD) network (NET-PD) included 91% Caucasian non-Latino patients, although PD is thought to be as common among African Americans and Latinos. Our purpose was to assess physicians' attitudes and beliefs about patient recruitment, particularly minorities, into clinical trials.

We surveyed 200 physicians from areas near the NET-PD clinics with > or =40% African Americans or Latinos. Physicians were asked about attitudes toward research, likelihood of referring patients to PD trials and past research participation, and administered the Trust in Medical Researchers Scale (TIMRS). Using logistic regressions, we identified physician characteristics associated with patient referral to clinical trials.

The TIMRS was lower among African-American physicians and physicians with high proportions of minority patients. Likelihood of trial referral was associated with previous referral to trials (OR=4.24, 95% CI: 2.09-8.62) and higher TIMRS (OR=1.06, 95% CI: 1.001-1.12). TIMRS results were similar among physicians not previously referring to trials.

Study results emphasize the importance of developing a trusting relationship with local physicians if investigators expect these physicians to refer their patients to clinical trials. The trust-related barriers for minority-serving physicians, regardless of their own race/ethnicity, seem to mirror the trust-related issues for their minority patients.