Abstract:
AIMS OF THE STUDY:Premature discontinuation occurs in about 25% of randomised clinical trials in Switzerland; it mainly affects investigator-initiated trials and is mostly due to problems with recruitment of patients. The aim of this study was to qualitatively investigate reasons for trial discontinuation due to poor patient recruitment and suggestions to address those reasons in the Swiss context. METHODS:We conducted semi-structured interviews with trialists whose trials were discontinued because of recruitment problems, other experienced trialists, and stakeholders in clinical research in Switzerland. Interviews were audio-recorded, transcribed verbatim, and anonymised. We analysed the transcripts using deductive coding and built up themes that were continuously discussed within the research team. RESULTS:Of 65 invited Swiss trialists and stakeholders, 39 (60%) agreed to be interviewed and contributed to this analysis. We identified four main themes of reasons for poor recruitment: (1) Switzerland has a decentralised healthcare system with many small hospitals and few patients per hospital, many research regulations, no standardisation of medical records across hospitals, and a heterogeneous ethics assessment of study protocols. There is little collaboration of different stakeholders in clinical research and a lack of prioritisation of projects. (2) Limited human and financial resources, especially in the academic setting, compromise research questions and size of clinical trials. When funding is used up this typically triggers discontinuation of already delayed clinical trials. (3) Investigators face underdeveloped research networks and a limited collaborative attitude among clinical researchers. They typically embark on clinical studies with a great deal of optimism but insufficient preparation. (4) Swiss patients have universal health coverage and many treatment options. Negative media coverage of clinical research and a lack of accessible information for patients about ongoing clinical studies frequently make participation in clinical trials less attractive. More interactive structures and collaboration across stakeholders were mentioned as potential solutions to tackle the problems. CONCLUSIONS:Recruitment of participants into clinical trials in Switzerland is challenging because of various, often interlinked factors related to the Swiss health system, available funding, investigators, and patients. Common goals and concerted efforts by involved stakeholders appear necessary to achieve improvement.
journal_name
Swiss Med Wklyjournal_title
Swiss medical weeklyauthors
Briel M,Elger B,von Elm E,Satalkar Pdoi
10.4414/smw.2017.14556subject
Has Abstractpub_date
2017-11-16 00:00:00pages
w14556eissn
1424-7860issn
1424-3997pii
smw-14556journal_volume
147pub_type
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journal_title:Swiss medical weekly
pub_type: 杂志文章
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journal_title:Swiss medical weekly
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journal_title:Swiss medical weekly
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journal_title:Swiss medical weekly
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pub_type: 杂志文章,评审
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更新日期:2005-02-05 00:00:00
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章
doi:10.4414/smw.2012.13570
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pub_type: 杂志文章,随机对照试验
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更新日期:2018-10-28 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章,随机对照试验
doi:10.4414/smw.2011.13239
更新日期:2011-07-30 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2013.13905
更新日期:2013-12-13 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2010.13040
更新日期:2010-07-22 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2001/05/smw-09667
更新日期:2001-02-10 00:00:00
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pub_type: 杂志文章
doi:smw-12604
更新日期:2009-09-05 00:00:00
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pub_type: 杂志文章
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2008/15/smw-12029
更新日期:2008-04-19 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2017.14469
更新日期:2017-07-24 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2015.14114
更新日期:2015-03-05 00:00:00
abstract::Sequencing the human genome was the big challenge of the last decade. Ten years later, the large amount of DNA sequences accumulated in our databases allows us to look at genome variations between humans. The level of complexity of these variations is much higher than previously expected. It goes from changes in the n...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2011.13321
更新日期:2011-12-19 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2015.14206
更新日期:2015-12-04 00:00:00
abstract::A laser scanning microscope collects information from a thin, focal plane and ignores out of focus information. During the past few years it has become the standard imaging method to characterise cellular morphology and structures in static as well as in living samples. Laser scanning microscopy combined with digital ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2010.13060
更新日期:2010-09-01 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2002/25/smw-09972
更新日期:2002-06-29 00:00:00
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pub_type: 杂志文章
doi:smw-12495
更新日期:2009-02-07 00:00:00
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journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2006/35/smw-11502
更新日期:2006-09-02 00:00:00
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pub_type: 杂志文章
doi:10.4414/smw.2010.13063
更新日期:2010-07-11 00:00:00