The Science of Clinical Trial Selection: Why Trial Type Matters to Patients

Living with a chronic illness or other condition can take up a significant piece of a patient's time. Though clinical trials can be beneficial to patients, recruitment efforts have to compete with many other products and services that can offer a patient support. 

Here at Antidote, we were interested in exploring the factors that impact a patient's interest in participating in a trial. We focused particularly on trial type with an additional focus on interest by race and socioeconomic status, as trials have traditionally struggled with racial diversity. We wanted to take a look at how patients of all backgrounds make the decision to participate, and wee also analyzed how patients living with different conditions responded to our questions.

In this blog post, we'll get into some of the highlights of what we found – for more insights, check out our full whitepaper, "Patients Have a Type."

Preferences by trial type and race

In our research, black, Hispanic, and other non-white respondents were more interested in participating in observational trials than white respondents were. 

Why might that be the case? To start, it's no secret that there has historically been an understandable lack of trust toward medical research from communities of color. At the same time, research suggests that trust ratings have improved. In a 2017 study conducted by Research!America, the percentage of respondents citing "lack of trust" as a reason to avoid medical research declined by

15 percentage points among minority groups and the population overall compared to the results of a 2013 survey:

  • 50% of African-Americans (11 percentage point decrease compared with 2013),
  • 5% of Asians (six percentage point decrease)
  • 43% of Hispanics (nine percentage point decrease)
  • 39% of non-Hispanic whites (15 percentage point decrease).

In our survey, we didn't ask respondents what appealed to them more about observational trials, but one reason may be that these kinds of trials are less risky. For those who are slowly warming up to the idea of research participation, trials that involve less risk may be more appealing. 

When creating outreach materials for observational or interventional trials, keep these preferences in mind. For both kinds of trials, you may highlight the importance of diverse participation in research, as people of different genetic backgrounds may have different responses to treatments. Steps can also be taken to build trust in the study by responding to patient questions, highlighting results from earlier trials, and explaining how the Institutional Review Board (IRB) process protects patients.

Preferences by trial type and condition area

We noticed a similar trend among patients living with chronic conditions: they were more interested than oncology patients (our reference group) in participating in observational trials. Many patients, such as those living with lupus, may experience a significant amount of trial and error before landing on a treatment that works for them. Once they find the right treatment, chronic disease patients may be hesitant to join a trial that requires them to stop their current regimen.

"With only one approved treatment specifically for lupus, people are taking medications borrowed from other diseases," said Diane Gross, National Director of Advocacy and Programs at the Lupus Research Alliance, in our whitepaper. "Once people find a treatment regimen that works, they don't necessarily want to take chances with something new."

Trial teams should have a deep understanding of patient need before launching a trial, and emphasize benefits to patients in outreach materials. For example, if existing treatments aren't effective for everyone or have severe side effects, those key details may be highlighted in outreach materials. Patients want to understand why taking the risk to participate in an interventional trial is worth it to them. 

General clinical trial preferences 

Across demographics and condition areas, patients were most interested in participating in clinical trials researching potential cures for their condition, and least interested in clinical trials looking for treatments for side effects associated with existing medications. 

For side effect clinical trials in particular, it can help to drive home other benefits of taking part in a trial. For example, one benefit of participating in a clinical trial for medication side effects may be that patients receive the existing medication for free.

It's much easier to recruit patients for a clinical trial if the trial itself meets patient needs. Involve patients in the design process, and make sure the trial reflects something patients truly want to improve in their own lives.

Want to learn more about how patient preferences impact clinical trial participation, and steps you can take to apply our findings? Download our free whitepaper below!