Table 3 Factors and opinions impacting provider participation in point of care studies
From: Provider experiences with and attitudes about an embedded pragmatic clinical trial
Theme | Description | Example Survey Comments |
|---|---|---|
Time | Providers are busy with non-research duties and are more willing to participate in research when time commitments are reasonable. | “This was nice that the provider had minimal involvement and the work was mostly done by the study and burden not placed on primary care or the providers.” “I am a busy clinician. Having a pragmatic RCT that minimizes the burden on the PCP is important in this day and age.” “Requirement for extra visits would discourage me.” “Honestly while I remember being told about the study and was happy to participate I do not remember spending any time on the study or it having any impact on care which I guess is a good thing” “This was nice that the provider had minimal involvement and the work was mostly done by the study and burden not placed on primary care or the providers” “Excellent job. Happy to participate. Minimal to no time required by PCPs is the key. There are always a few pt questions and some want to talk to their PCP: that’s true of any study. Fine. After that: PCP workload mgmt is the critical factor in success of these studies.” |
Education | Providers want to know about research taking place with their patients, including updates during the study where possible. | “I didn’t receive any education material our have any interaction with DCP outside of the email asking for participation.” “Ongoing updates on enrollment (or pauses due to challenges)” “It would be nice if you sent an abstract summarizing the study’s results directly to clinicians who participated in the study. You know our emails and watching journals may not be everyone’s habits.” “I think the educational information prior to the study was critical.” “You could/should have sent prescriber participants an annual ‘POC research update’.” |
Safety | Providers primary priority with their patients is safety. | “Baseline safety of the meds being studied [would affect my decision to participate].” “I liked that it was easy to implement and was a comparison of similar drugs so some patients were not getting inferior care with this model.” “Chlorthalidone v HCTZ has had disastrous time consuming results, several of these patients wound up in ED for hyponatremia or dehydration. The increased incidence of adverse effects has thus far outweighed benefit of chlorthalidone v hctz. Patients need to be more closely evaluated (both their physiology and their health literacy and behaviors) before trying chlorthalidone.” |
Compensation | Providers desire additional compensation when asked to participate in research beyond their normal duties. | “Authorship (not just acknowledgment) in publications [would affect my decision to participate].” “Would prefer to be local PI.” “If you want me to spend time on something, provide compensation for it: reduced panel size, etc. Alternatively, just handle everything within the study: lab f/u, BP f/u, etc. My job as a PCP is not to assist research staff with their projects.” |
Importance of Study Question | Provider acceptance of the clinical question to be studied will affect their willingness to participate. | “My perception of the value of the study to the practice of primary care [would affect my decision to participate].“ “I would need to feel the question is important and that our knowledge about the treatments showed them to be close enough in efficacy that it would be ethical to place a patient on either treatment.” “I also wish we had more head to head comparisons of classes of medications, similar to [ALLHAT]. I worry that we are relying so heavily on network meta-analyses for these comparisons.” “Do a research that was not done prior.” “I appreciate the work to understand the difference in these medications. It is a big question in patient care. I am not sure if this helped answer the questions.” |
Patient-Provider Relationship | Providers are willing to participate in studies when their relationship and trust with their patients is uncompromised. | “Neg[ative] impact on patient doctor relationship [would affect my decision to participate]” “This study did not affect regular patient care and management did not change as a result of the study. This is was very important to me as a provider. “ “Should not take me away from regular patient care.” “It did not dramatically impact my patient care and patient’s did not feel affected by the options.” |