Physicians' perceptions of an electronic health record-based clinical trial alert approach to subject recruitment: a survey

• Published in: BMC medical informatics and decision making 2008-04, Vol.8 (1), p.13-13, Article 13
• Main Authors: Embi, Peter J, Jain, Anil, Harris, C Martin
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Attitude to Computers; Clinical Trials as Topic; Data Collection; Endocrinology; Family Practice; Female; Humans; Male; Medical records; Medical Records Systems, Computerized; Patient Selection; Physicians; Physicians - psychology; Physicians - statistics & numerical data; Point-of-Care Systems; Practice; Reminder Systems; Surveys; Surveys and Questionnaires
• ISSN: 1472-6947; 1472-6947
• DOI: 10.1186/1472-6947-8-13

Physician participation in clinical research recruitment efforts is critical to many studies' success, but it is often limited. Use of an Electronic Health Record (EHR)-based, point-of-care Clinical Trial Alert (CTA) approach has led to significant increases in physician-generated recruitment and holds promise for wider benefit. However, little is known about physicians' decision-making regarding recruitment in EHR-equipped settings or the use of such EHR-based approaches. We sought to assess physicians' perceptions about recruitment in general and using the CTA approach in particular. We developed and delivered a Web-based survey consisting of 15 multiple-choice and free-text questions. Participants included the 114 physician subjects (10 endocrinologists and 104 general internists) who were exposed to CTAs during our preceding 4-month intervention study. Response data were descriptively analyzed, and key findings were compared between groups using appropriate statistical tests. Sixty-nine physicians (61%) responded during the 10-week survey period. Respondents and non-respondents did not differ significantly. Twenty-seven percent of respondents felt very comfortable recruiting patients to trials in general, and 77% appreciated being reminded about a trial via a CTA. Only 11% percent felt the CTA was difficult to use, and 27% felt it was more than somewhat intrusive. Among those who ignored all CTAs, 37% cited a lack of time, 28% knowledge of the patient's ineligibility, and 13% limited knowledge about the trial as their most common reason. Thirty-eight percent wanted more information about the trial presented in the CTA, and 73% were interested in seeing CTAs for future trials. Comments and suggestions were submitted by 33% of respondents and included suggestions for improvement of the CTA approach. Most physicians were comfortable recruiting patients for clinical trials at the point-of-care, found the EHR-based CTA approach useful and would like to see it used in the future. These findings provide insight into the perceived utility of this EHR-based approach to subject recruitment, suggest ways it might be improved, and add to the limited body of knowledge regarding physicians' attitudes toward clinical trial recruitment in EHR-equipped settings.