There is a strong disparity in the US between the proportion of physicians who express a keen interest in participating in clinical research and those who actually do so. Within the latter category, though, there are further disparities in terms of race and gender, a recent study by the Tufts Center for the Study of Drug Development (CSDD) found.
According to the study, which was reported in the November/December Tufts CSDD Impact Report, more than 70% of all physicians, regardless of race and gender, voice a strong desire to participate in clinical studies. Yet among those who actually follow through on that aspiration, 16.9% of White physicians participate in trials as principal investigators compared with 14% of Black, 10.8% of Hispanic and 9.6% of Asian physicians.
Looked at by gender, only 10.9% of female physicians participate in trials as principal investigators, compared with 16.9% of male physicians, the Tufts researchers discovered. Moreover, minority and female clinical investigators initiated far fewer clinical studies each year than their White or male counterparts.
These disparities may have a significant impact on recruitment patterns in clinical development, given the perceived historical reluctance of some minorities to take part in trials. In the Tufts study, more than half of Black (51%) and Hispanic (57%) physicians said they considered a doctor’s race an important factor in influencing minority patient participation in clinical research, compared with 9% of White and 21% of Asian physicians.
On the other hand, minority physicians were less likely to refer their patients for clinical studies than their White counterparts (38% versus 48% respectively). This trend was segmented by race, however: of those physicians who did refer patients, the Tufts study found, White and Black physicians on average referred twice as many patients for clinical studies than their Asian and Hispanic counterparts.
Barriers to participation
All physicians, regardless of race or gender, cited similar barriers to participation as investigators in clinical trials – namely, time constraints, personnel needs and lack of infrastructure. But the Tufts study, which was based on surveys of nearly 1,400 physicians, also revealed that principal investigator experience and infrastructure available to support clinical research activity were at a considerably lower level among minority and female investigators than among White and male investigators.
For minority physicians, time constraints and lack of infrastructure, such as dedicated personnel and office space, were cited as key barriers preventing their participation as investigators to the same degree as their White counterparts.
The same major obstacles were identified by female physicians, who also said that distrust of the healthcare system and child care issues were the main factors limiting their patients’ participation in clinical research. Female investigators in the US initiate only one third the number of clinical studies each year that their male counterparts initiate.
