Report: Poor physician/nurse engagement contributes to low patient recruitment rates

Although physicians and nurses are familiar with, and comfortable discussing, clinical trials, they refer a mere fraction of their patients for these studies, reflecting, in part, a failure by sponsors, CROs and investigative site personnel to engage health care providers as partners in the clinical research process, according to a recently completed analysis conducted by the Tufts Center for the Study of Drug Development.

The study, based on a survey of 2,000 physicians and nurses primarily in the U.S. and Europe, found that nearly all physicians (91%), and the majority of nurses (72%) feel “somewhat” or “very” comfortable discussing the opportunity to participate in a clinical trial with patients, but physicians refer less than 0.2% of their patients into clinical trials, and nurses refer even fewer.

According to Ken Getz, associate professor and director of sponsored research at Tufts CSDD, who led the study, lack of familiarity and comfort level with referring patients into clinical trials on the part of physicians and nurses are often cited to explain low referral rates. However, he noted, the study results show that these factors are playing a much smaller role.

"The study results challenge the long-held notion that health care providers are a barrier to recruitment, and suggest opportunities to rethink and leverage the role of healthcare providers as facilitators and critical partners in engaging patients before and during clinical trial participation," said Getz.

Key survey findings, reported in the January/February Tufts CSDD Impact Report, include the following:

Physicians and nurses cite the inability to access information and insufficient information and time as key reasons for not referring patients into clinical trials.
Only 9% of physicians and 2% of nurses say fear of losing patients influences their decision not to refer.
Physicians in clinical practice are 2.7 times more likely to refer their patients into clinical trials than physicians in hospital-based settings.
Nearly 30% of physicians and 45% of nurses reported never receiving initial or follow-up contact from investigative site staff following a referral, and a higher percentage reported never receiving their patients’ clinical trial results.