Awareness and attitude of Saudi cancer patients toward participation in clinical research
Background: Public awareness about the importance of clinical research (CR) is crucial for patient’s participation in clinical trials. Their enrollment may be impacted by their levels of awareness and attitudes toward participation. Our study aimed to assess the Saudi cancer patient’s knowledge and perception about CR, and determine the influencing factors and barriers affecting participation.
Methods: A cross-sectional study was conducted in 300 cancer patients attending the Oncology Department at King AbdulAziz Medical City (KAMC) Riyadh between February 2011 and February 2012 using a survey covering the demographic data, knowledge of clinical research, and attitude toward participation; followed by statistical analysis.
Results: A total of 300 patients were enrolled in the study with a median age of 53.6 (42.2-64.01); 62.67% of which were females. The majority of patients (97.31%) were not aware of Institutional Review Board (IRB). However, (75.33%) showed interest in CR participation, if offered. The advanced disease (86.67%), and the lack of other treatment options (85.33%) were the top two encouraging factors, while fear of adverse side effects (58.33%), and the unknown efficacy of treatment (58.32%) were the top two barriers against participation. Respondents younger than 45 years, and educated ones were significantly more interested in participation in CR with P values P=0.0136 and P=0.0239 respectively.
Conclusions: There is an apparent gap in cancer patient’s awareness about CR. However, there is an obvious interest in participation in CR especially in younger and educated patients. Enhancing public awareness is crucial to improve participation in CR.
Jenkins V, Farewell V, Farewell D, Darmanin J, Wagstaff J, Langridge C, et al. Drivers and barriers to patient participation in RCTs. Br J Cancer. 2013;108(7):1402-7.
Khalil S, Silverman J, Raafat M, El-Kamary S, El-Setouh M. Attitudes, understanding, and concerns regarding medical research amongst Egyptians: a qualitative pilot study. BMC Medical Ethics. 2007;8(1):9.
Tournoux C, Katsahian S, Chevret S, Levy V. Factors influencing inclusion of patients with malignancies in clinical trials. Cancer. 2006;106(2):258-70.
Ellis M, Phyllis N, Martin T, Stewart D, Nehmat H. Randomized Clinical Trials in Oncology: understanding and attitudes predict willingness to participate. J Clin Oncol. 2001;19(15):3554-61.
Lara N, Higdon R, Lim N, Kwan K, Tanaka M, Lau D. Prospective evaluation of cancer clinical trial accrual patterns: identifying potential barriers to enrollment. J Clin Oncol. 2001;19(6):1728-33.
Sood A, Prasad K, Chhatwani L, Shinozaki E, Cha S, Loehrer L. Patients' attitudes and preferences about participation and recruitment strategies in clinical trials. Mayo Clinic Proceedings. 2009;84(3):243-7.
Albrecht T, Christina B, John R, Michael C, Rebecca S. Strategic physician communication and oncology clinical trials. J Clin Oncol. 1999;17(10):3324-32.
Grant C, Cissna K, Rosenfeld L. Patients' perceptions of physicians communication and outcomes of the accrual to trial process. Health Commun. 2000;12(1):23-39.
Fetting J, Siminoff L, Piantadosi S, Abeloff M, Damron D, Sarsfield A. Effect of patients expectations of benefit with standard breast cancer adjuvant chemotherapy on participation in a randomized clinical trial: a clinical vignette study. J Clin Oncol. 1990;8(9):1476-82.
Sheldon J, Fetting J, Siminoff L. Offering the option of randomized clinical trials to cancer patients who overestimate their prognoses with standard therapies. Cancer investigation. 1993;11(1):57-62.
Catania C, De Pas T, Goldhirsch A, Radice D, Adamoli L, Medici M, et al. Participation in clinical trials as viewed by the patient: understanding cultural and emotional aspects which influence choice. Oncology. 2007;74(3-4):177-87.
Biedrzycki B. Decision making for cancer clinical trial participation: a systematic review. Oncol Nurs Forum. 2010;37(6):E387-99.
Baquet C, Henderson K, Commiskey P, Morrow J. Clinical trials: the art of enrollment. Semin Oncol Nurs. 2008;24(4):262-9.
Madsen S, Holm S, Riis P. Attitudes towards clinical research among cancer trial participants and non-participants: an interview study using a grounded theory approach. Journal of medical ethics. 2007;33(4):234-40.
Yanagawa H, Kishuku M, Akaike M, Azuma H, Irahara M. View of physicians on and barriers to patient enrollment in a multicenter clinical trial: experience in a Japanese rural area. Int Arch Med. 2010;3(1):7.
Bazarbashi S, Hassan A, MohiEldin A, Soudy H, Hussain F. Awareness and perceptions of clinical trials in cancer patients and their families in Saudi Arabia. Journal of Cancer Education. 2015;30(4):655-9.
AL-Tannir M, El-Bakri N, Abu-Shaheen A. Knowledge, attitudes and perceptions of Saudis towards participating in clinical trials. PloS one. 2016;11(2):e0143893.
Almutairi K, Alonazi W, Alodhayani A, Vinluan J, Moussa M, Al-Ajlan A, et al. Barriers to Cancer Clinical Trial Participation Among Saudi Nationals: A Cross-Sectional Study. J Relig Health. 2017;56(2):623-34.
Comis R, Miller J, Aldige C, Krebs L, Stoval E. Public attitudes toward participation in cancer clinical trials. J Clin Oncol. 2003;21(5):830-5.
Mills E, Seely D, Rachlis B, Griffith L, Wu P, Wilson K, et al. Barriers to participation in clinical trials of cancer: a meta-analysis and systematic review of patient-reported factors. Lancet Oncol. 2006;7(2):141-8.