Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: This study investigated factors that influence emergency medicine (EM) patients’ decisionsto participate in clinical trials and whether the impact of these factors differs from those of other medicalspecialties.

Methods: A survey was distributed in EM, family medicine (FM), infectious disease (ID), and obstetrics/gynecology (OB/GYN) outpatient waiting areas. Eligibility criteria included those who were 18 years ofage or older, active patients on the day of the survey, and able to complete the survey without assistance.We used the Kruskal-Wallis test and ordinal logistic regression analyses to identify differences inparticipants’ responses.

Results: A total of 2,893 eligible subjects were approached, and we included 1,841 surveys in the final analysis. Statistically significant differences (p≤0.009) were found for eight of the ten motivating factorsbetween EM and one or more of the other specialties. Regardless of a patient’s gender, race, andeducation, the relationship with their doctor was more motivating to patients seen in other specialties thanto EM patients (FM [odds ratio {OR}:1.752, 95% confidence interval {CI}{1.285-2.389}], ID [OR:3.281,95% CI{2.293-4.695}], and OB/GYN [OR:2.408, 95% CI{1.741-3.330}]). EM’s rankings of “how well theresearch was explained” and whether “the knowledge learned would benefit others” as their top twomotivating factors were similar across other specialties. All nine barriers showed statistically significantdifferences (p≤0.008) between EM and one or more other specialties. Participants from all specialtiesindicated “risk of unknown side effects” as their strongest barrier. Regardless of the patients’ race, “timecommitment” was considered to be more of a barrier to other specialties when compared to EM (FM[OR:1.613, 95% CI{1.218-2.136}], ID [OR:1.340, 95% CI{1.006-1.784}], or OB/GYN [OR:1.901, 95%CI{1.431-2.526}]). Among the six resources assessed that help patients decide whether to participate ina clinical trial, only one scored statistically significantly different for EM (p<0.001). EM patients ranked“having all material provided in my own language” as the most helpful resource.

Conclusion: There are significant differences between EM patients and those of other specialties in thefactors that influence their participation in clinical trials. Providing material in the patient’s own language,explaining the study well, and elucidating how their participation might benefit others in the future mayhelp to improve enrollment in EM-based clinical trials. [West J Emerg Med. 2017;18(5)846-855.]