Consultants attitudes to consumer involvement in clinical research Rachel Thompson, Alan Horwich,...

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Consultants attitudes to Consultants attitudes to consumer involvement in consumer involvement in

clinical researchclinical research

Rachel Thompson, Alan Horwich, Jim Laxton, Joe Flaherty, Andy Norman,

Barbara Pearce, John Baart

IntroductionIntroduction

Consumer Research Advisory Group CRAG4(7) consumers1 Secretary1 Clinical lead

Group RemitWork with researcher to ensure research is important to both HCPs and ConsumersProduce consumer friendly protocols

Don’t know how many researchers are pro consumer involvement and how many currently work with

consumers

AimsAims

To identify possible roles for members of the Consumer Research Advisory Group (CRAG)

To give group members the opportunity to gain an greater understanding of research through experience

To identify what training if any was needed

To identify any barriers to consumer involvement, those consultants experienced in working with consumers and the motivators

MaterialsMaterials

A questionnaire was designed consisting of Y/N questions, open questions with free text response, and statements for comment on level of agreement or disagreement

INVOLVE’S definitions of Consultation, Collaboration and User Controlled were given at the beginning of the questionnaire

Name and contact details requested for those consultants wishing to work with the group members

1. Are you aware that there are government initiatives to promote user involvement in clinical research?

YES/NOYES/NO

2. Have you ever been involved in clinical research that has consulted users for their views on the overall project design or patient information sheet?

YES/NOYES/NO

3. Have you been involved in clinical research that has collaborated with users in the entire research process eg design, monitoring, analysis and dissemination?

YES/NOYES/NO

Questionnaire: Y/N ExamplesQuestionnaire: Y/N Examples

• What role, if any, do you think there is for users within the clinical research process?

• What specific training do you think the members would require?

• Please make any other comments you wish about the issues and challenges of user involvement in clinical research

Questionnaire: Free Text ExamplesQuestionnaire: Free Text Examples

1. Collaboration results in a more user friendly research project thus aiding patient recruitment

2.    Collaboration is time consuming with minimal benefits

3. Collaboration will result in loss of control over the research project due to the active involvement of users

Strongly Strongly agreeagree

AgreeAgree DisagreeDisagree Strongly Strongly disagreedisagree

Don’t knowDon’t know

xx

Questionnaire: Statement ExamplesQuestionnaire: Statement Examples

MethodMethod

Postal questionnaire was sent to 250 Consultants working in an oncology setting within the South West London Cancer Research Network.

A reminder letter was sent after 2 weeks.

The data was entered into an Access Database specifically designed for the study and then exported into Excel Spreadsheets for analysis

Consultants were stratified according to their speciality, sub-speciality, place of work and previous research role

SOUTH WEST LONDON

CANCER RESEARCH NETWORK

Consumer Research Advisory Group

“CRAG”

Survey of Consultants’ Views

On User Involvement

in Clinical Research

250 questionnaires 93 responses

157 non respondents

1 Unaware of Government initiatives or CRAG

2. Little or no interest in consumer involvement

3. Hostility to consumer involvement

4. To busy to fill in non essential forms

Principal investigators.

V

Other consultants.

Consultants who were aware of government initiatives

0

10

20

30

40

50

60

70

Yes No

Nu

mb

er o

f re

spo

nd

ents

66%34%

Consultants who had consulted with users

0

10

20

30

40

50

60

70

80

Yes No

Nu

mb

er

of

res

pn

de

nts

28%

72%

Consultants who had collaborated with users

0

10

20

30

40

50

60

70

80

90

Yes No

Nu

mb

er o

f re

spo

nd

ents

91%9%

“What role if any

do you think there is for users

within the clinical research process”

Consultation RoleAreas for Consultation Number %

Patient Information 23 47%

Practicability Assessment 13 27%

Ethics 11 22%

Quality of Life Issues 7 14%

Patient Support Services 3 6%

Legislation/Compliance 1 2%

Total no of consultants commenting on consultation 49

 

Consultation RoleAreas for Consultation Number %

Patient Information 23 47%

Practicability Assessment 13 27%

Ethics 11 22%

Quality of Life Issues 7 14%

Patient Support Services 3 6%

Legislation/Compliance 1 2%

Total no of consultants commenting on consultation 49

 

Collaboration RoleAreas for Collaboration Number % of

consultants

Study Design 24 56%

Feedback/Review 12 28%

Dissemination 7 16%

Viable Research Question 6 14%

Promotion 4 9%

Improving Communications 1 2%

Total no of consultants commenting on consultation

43  

CollaborationAreas for Collaboration Number % of

consultants

Study Design 24 56%

Feedback/Review 12 28%

Dissemination 7 16%

Viable Research Question 6 14%

Promotion 4 9%

Improving Communications 1 2%

Total no of consultants commenting on consultation

43  

Collaboration

Study Design 56%

Feedback/Review 28%

 

“To ensure that protocols are acceptable to patients

and that questionnaires are clear”

User Controlled Research

10 responses

User Controlled Research

10 responses

“Decision making” “Research questions”

“What specific training

do you think

the members would require”

56 responses

•Research Methodology •Experience and/or knowledge of cancer

•No training

“…. knowledge of statistics”

“For clinical trials they would need training in basic statistical theory and the practice of

trials”

Research Methodology

Experience and/or knowledge of

cancer

8 respondentsConsidered essential by

No training

2 respondents

No training

•“None, they will only be consulted in their role as patients and not as experts”

•“No specific training since this may bias the actual benefit of asking potential patients for their

opinion”.

“ Any other comments you wish to make about

The issues and challenges of user involvement in clinical research”

 

29 (31%) of the 93 respondents

Positive

Negative

Miscellaneous.

Positive

Negative 75%

Miscellaneous.

• User selection

• Time commitment

• Cost

• Consumers’ lack of understanding

Positive

Negative 75%

Miscellaneous.

• User selection

• Time commitment

• Cost

• Consumers’ lack of understanding

“Users will have to be carefully selected to check their reasons for wishing to

become involved” 

“The usual difficulty is finding representatives with

enough time and skills to contribute while not having narrow preconceptions due

to personal experience”

Positive 20%

Negative

Miscellaneous.

• patient information

• research design

Positive 20%

Negative

Miscellaneous.

• patient information

• research design

“use of simple English for the patient consent

documents”

 

“consultation with users is very …informative”

Positive 20%

Negative

Miscellaneous.

Positive 20%

Negative

Miscellaneous.

“Needs to be simple and non bureaucratic”

 

“This must not be done simply because it is seen to

be politically correct”

 

“User input has not been assessed – this is a project

in itself”

The following statements are designed to assess your views on user involvement in clinical research. Please could you circle the most appropriate response?

1. The consultation of users in the clinical research process enables researchers to obtain user views without having to commit to acting on them.

2. Consultation is the most effective and efficient means of involving

users in the clinical research process.

3. Consultation does not allow the user to make a definite contribution to the clinical research decision making process.

4. Consumer involvement will help to achieve the objectives of the research project.

5. Consumer involvement will improve the quality of the research project.

6. Collaboration results in a more user friendly research project thus aiding patient

recruitment.

7. Collaboration is time consuming with minimal benefits.

8. Collaboration will result in loss of control over the research project due to the active involvement of users.

9. Users can help to interpret and understand research data once analysed.

10. Involving users in the clinical research process means that questions are addressed

which are considered important by both researcher and user.

11. User involvement will increase the cost of the research project.

12. User involvement will increase the timescale of the research project.

13. User involvement will increase the “value for money” of research projects

14. User involvement is of no benefit to clinical research

15. User involvement will help to target or prioritise research projects

16. User involvement will help to obtain funding for a research project

Strongly Agree

Agree Disagree Strongly Disagree

Don’t Know

Statements testing a positive response to user involvement

0

10

20

30

40

50

60

70

strongly agree agree disagree stronglydisagree

don't know

Num

ber o

f res

pode

nts 62%62% 21%21% 17%17%

Statements testing a negative response to user involvement

0

10

20

30

40

50

60

70

stronglyagree

agree disagree stronglydisagree

don't know

Nu

mb

er

of

resp

on

den

ts

73%15% 12%

1 The consultation of users in the clinical research process enables researchers to obtain user views without having to commit to acting on them

0

10

20

30

40

50

60

strongly agree agree disagree stronglydisagree

don't know

0

10

20

30

40

50

60

strongly agree agree disagree stronglydisagree

don't know

No.

of R

espo

ndan

ts

Qu. 2. Consultation is the most effective and efficient means of involving users in the clinical research process

6 Collaboration results in a more user friendly research project thus aiding patient recruitment

0

10

20

30

40

50

60

strongly agree agree disagree stronglydisagree

don't know

Qu. 8.Collaboration will result in loss of control over the research project due to the active

involvement of users 

0

10

20

30

40

50

60

strongly agree agree disagree stronglydisagree

don't know

0

10

20

30

40

50

60

strongly agree agree disagree stronglydisagree

don't know

Qu. 16. User involvement will help to obtain funding for a research project

0

5

10

15

20

25

30

35

40

45

strongly agree agree disagree strongly disagree don't know

No

. o

f re

spo

nd

ents

4. User involvement will help to achieve the objectives ofthe research project

5. Consumer involvement will improve the quality of theresearch project

0

10

20

30

40

50

60

stronglyagree

agree disagree stronglydisagree

don't know

User involvement will help to target or prioritise research projects

0

10

20

30

40

50

60

strongly agree agree disagree stronglydisagree

don't know

Users can help to interpret and understand research data once analysed

Statements adressing concerns over costs and time

0

10

20

30

40

50

60

strongly agree agree disagree stronglydisagree

don't know

Nu

mb

er

of

resp

on

den

ts