Influence of Cost-Related Considerations on Clinical Trial Participation: Results from the 2020 Health Information National Trends Survey (HINTS)
- 30 November 2022
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of General Internal Medicine
- Vol. 38 (5), 1200-1206
- https://doi.org/10.1007/s11606-022-07801-0
Abstract
Background People experiencing financial burden are underrepresented in clinical trials. Objective Describe the prevalence of cost-related considerations influential to trial participation and their associations with person-level characteristics. Design This cross-sectional study used and assessed how three cost-related considerations would influence the decision to participate in a hypothetical clinical trial. Participants A total of 3682 US adult respondents to the Health Information National Trends Survey Main Measures Survey-weighted multivariable logistic regression estimated associations between respondent characteristics and odds of reporting cost-related considerations as very influential to participation. Key Results Among 3682 respondents, median age was 48 (IQR 33–61). Most were non-Hispanic White (60%), living comfortably or getting by on their income (74%), with ≥ 1 medical condition (61%). Over half (55%) of respondents reported at least one cost-related consideration as very influential to trial participation, including if usual care was not covered by insurance (reported by 42%), payment for participation (24%), or support for participation (24%). Respondents who were younger (18–34 vs. ≥ 75, adjusted odds ratio [aOR] 4.3, 95% CI 2.3–8.1), more educated (high school vs. <high school, aOR 2.1, 95% CI 1.1–4.1), or with lower perceived income (having difficulty vs. living comfortably, aOR 2.1, 95% CI 1.1–3.8) had higher odds of reporting any cost-related consideration as very influential to trial participation. Non-Hispanic Black vs. non-Hispanic White respondents had 29% lower odds (95% CI 0.5–0.9) of reporting any cost-related consideration as very influential to trial participation. Conclusions Cost-related considerations would influence many individuals’ decisions to participate in a clinical trial, though prevalence of these concerns differed by respondent characteristics. Reducing financial barriers to trial participation may promote equitable trial access and greater trial enrollment diversity.Keywords
This publication has 20 references indexed in Scilit:
- A Nonresponse Bias Analysis of the Health Information National Trends Survey (HINTS)Journal of Health Communication, 2017
- Socioeconomic burden of participation in clinical trials in patients with myeloproliferative neoplasmsEuropean Journal of Haematology, 2017
- Access to Accredited Cancer Hospitals Within Federal Exchange Plans Under the Affordable Care ActJournal of Clinical Oncology, 2017
- Barriers to Clinical Trial Enrollment in Racial and Ethnic Minority Patients with CancerCancer Control, 2016
- Financial Burden of Cancer Clinical Trial Participation and the Impact of a Cancer Care Equity ProgramThe Oncologist, 2016
- Patient Income Level and Cancer Clinical Trial ParticipationJournal of Clinical Oncology, 2013
- Why Does Patient Activation Matter? An Examination of the Relationships Between Patient Activation and Health-Related OutcomesJournal of General Internal Medicine, 2011
- Perceptions of Reimbursement for Clinical Trial ParticipationJournal of Empirical Research on Human Research Ethics, 2011
- More than Tuskegee: Understanding Mistrust about Research ParticipationJournal of Health Care for the Poor and Underserved, 2010
- Effects of Survey Mode, Patient Mix, and Nonresponse on CAHPS® Hospital Survey ScoresHealth Services Research, 2009