Support for clinical research: perceived “barriers” to participation
fracture
SAID
When interviewees were asked for their general attitudes toward research, they universally proclaimed strong support. Research is “a necessity for the advancement of medicine,” one anesthesiologist said (interviewee 23), is “absolutely necessary to improve care,” responded another (interviewee 15), and is “the only way we’re gonna move forward,” said a third (interviewee 14). Such categorical statements were common, as were avowals that clinical research is a major influence on how they practice. “I’ve always based my practice […] on the best-practice models from current research,” remarked one anesthesiologist (interviewee 12). This enthusiasm extended to the REGAIN trial, which many interviewees stressed would usefully inform how they approach hip fracture cases.If the REGAIN study shows me that there’s ten percent better outcomes with people who get a spinal, I’m gonna try to put a spinal on every single hip fracture patient, because we’d be providing better care. (interviewee 3)Nearly all interviewees said that participation in clinical research should be viewed as a responsibility for physicians. Two interviewees opined that the rights of physicians who chose not to participate in research should be respected. One said that not all physicians should participate in research, basing this view on a concern that unenthusiastic physicians will not rigorously follow study protocols.When we asked anesthesiologists what in their experience were general “barriers” to integrating clinical research into their practice, their responses focused on production pressure and associated lack of time, the potential for clinical studies to disrupt workflow (e.g., having to answer the “stupid phone calls from the research assistants” (interviewee 19)), and the failure to sometimes get timely notifications about the randomization of their patients from study staff. They did not bring up discomfort with patient eligibility determinations as a “barrier,” despite having often talked extensively about this issue in the chart-stimulated portion of the interview a few minutes earlier.