Physicians report referring patients to clinical trials, sponsors assume they don't: BBK

01-Jul-2019 - Last updated on 01-Jul-2019 at 14:07 GMT

(Image: Getty/PrathanChorruangsak)

Many sponsors think physicians are unwilling to refer their patients to clinical trials, though the majority have, per a recent BBK survey, which suggest that more patients could be enrolled in studies if doctors had more information about protocols.

The survey contests the so-called “myth” – stemming from multiple sources – that physicians do not refer patients to clinical trials, said Matt Kibby, principal and president, BBK Worldwide (BBK). This notation has “built up to such a critical mass” that BBK decided to test the hypothesis, he told us.

The survey was conducted in part with Health Union between April and June of this year and includes responses from 655 patients, 131 physicians, and 194 study sponsors.

“There was a general acceptance – particularly among sponsors – that referrals don’t happen,” explained Kibby, who discussed the survey findings last week during the DIA Annual Meeting.

According to the survey findings, 53% of sponsors believe that doctors are unwilling to refer patients to other specialists in order to access clinical trials – though 69% of doctors said they had referred a patient.

Said Kibby, “Part of the assumption is that patients with chronic health conditions represent a revenue stream that doctors are fearful of losing – although this may be more of an American phenomenon.”

However, the majority of doctors (68%) reported that they did not refer a patient due to a lack of information about the study protocol. “In order to have more confidence that their patients are suitable for enrollment, they need more information than what’s currently available on ClinicalTrials.gov – more technical, more medical information,” Kibby said.

Per the report, only 9% of doctors were concerned about losing revenue, with more than one-third of all patients in clinical trials reporting having been referred by a doctor who was not an investigator, explained Kibby. “Therefore, the importance of this starts to take on a greater sense of urgency when you consider that number could and should be higher,” he added. “Maybe even 50%.”

Of those patients not referred to a clinical trial, 71% said they would have wanted to participate if referred to a different doctor. Additionally, 79% of patients who had been referred to a specialist as part of a clinical trial returned to their regular doctor for treatment. After the study ended, 11% continued to see both their study doctor and regular doctor, according to the report.

The paradox

Through the research, what Kibby found post surprising was that the patients who were most satisfied with their doctor were those were most likely to participate in a clinical trial. “Upon reflection it may not be that surprising at all,” he added, “but rather a paradox.”

“You may be inclined to think that most patients enroll in a clinical trial because their current efforts are not working and they need to explore other options – or maybe they are not satisfied with their current doctor – but it really boils down to the fact that patients who have the best relationship with their doctors are the ones that are exploring the options together,” said Kibby.

“For physicians on the fence about introducing clinical trials as a potential treatment option with their patients, the message couldn’t be clearer – talking about clinical trials with your patients has the potential to enhance your relationship as it reinforces your care and concern.”