Cancer prevention trials and primary care physicians: factors associated with recommending trial enrollment
Department of Quantitative Health Sciences
Aged; Attitude of Health Personnel; Chemoprevention; *Clinical Trials as Topic; Counseling; *Decision Making; Family Practice; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Neoplasms; Patient Acceptance of Health Care; *Patient Selection; Physician's Practice Patterns; Physicians, Family
Biostatistics | Epidemiology | Health Services Research
BACKGROUND: To explore the willingness of primary care providers (PCPs) to encourage enrollment of patients into cancer prevention trials.
METHODS: A self-administered survey was mailed to a random sample of PCPs in three geographic regions. Physicians were asked questions about their knowledge and attitudes towards cancer prevention trials. We presented a clinical vignette of a woman at high risk for breast cancer and asked if they would encourage her enrollment into a breast cancer chemoprevention trial (yes/no). Each survey included one of 16 possible clinical vignettes where patient characteristics (age, race socioeconomic status, physical mobility and co-morbidity) varied dichotomously. Bivariate analyses and logistic models were used to examine the independent effects of patient and physician characteristics on physician decisions.
RESULTS: Two hundred and sixty-six surveys (50% response) were analyzed. The mean age of respondents was 48; 54% were White, 35% Asian and 5% Black. By design physicians were evenly distributed by gender, specialty and geographic location. Overall, 53% would encourage enrollment into a breast cancer chemoprevention trial. Significant predictors of a recommendation to enroll were: geographic location in California or Georgia, younger vignette patient and anticipating an increase in patient trust after recommending enrollment.
CONCLUSION: PCPs are less likely to encourage elderly patients to enroll into cancer chemoprevention trials. Decisions differ based on geographic location and perceived trust in the patient-provider relationship. To achieve successful enrollment, trial investigators must continue to educate PCPs and ensure a strong PCP-patient relationship is maintained.
DOI of Published Version
Cancer Detect Prev. 2006;30(1):34-7. Epub 2006 Feb 14. Link to article on publisher's site
Cancer detection and prevention
Battaglia, Tracy A.; Ash, Arlene S.; Prout, Marianne N.; and Freund, Karen M., "Cancer prevention trials and primary care physicians: factors associated with recommending trial enrollment" (2006). Quantitative Health Sciences Publications and Presentations. 731.