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Research article
Identifying Physician-perceived Barriers to Apragmatictreatment Trial Inrheumatoid Arthritis
Jasvinder Singh
University of Alabama at Birmingham
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3485-0006
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: The aim of this qualitative research was to identify physician-perceived patient and clinic barriers to patient recruitment in a RA pragmatic trial of anti-TNF biologic vs. non-TNF biologic/Janus-Kinase inhibitor initiation after an inadequate response to methotrexate (MTX-IR).
Methods: Semi-structured telephone interviews were conducted with 26 rheumatologists in March 2019. An exploratory thematic analysis approach was used to analyze the interview data.
Results:Physician perceived patient barriers to the implementation ofa RA pragmatic trial. This theme covers three sub-themes: 1) patients’ personal barriers, 2) patients’ treatment-related factors, and 3) trial-related factors (e.g., patient recruitment, side effects, mode of use, etc.). Physicians perceived clinic barriers interfered with the pragmatic trial enrollment from the clinic or the healthcare system perspective. This theme covered four sub-themes: 1) clinic-related factors, 2) patient-related factors, 3) research personnel, and 4) facilitators (positive factors of the clinic).
Conclusions: Our results from the inductive thematic analysis will help researchers understand the key patient and clinic/system factors/barriers that may influence pragmatic RA trial implementation. The themes suggest there are factors that can be modified (e.g., coordinator effort needed, effective patient recruitment during clinic visits, provider engagement) and challenges to overcome (patient insurance status, busy clinic flow, and space issues including limited number of patient rooms). In summary, these themes provide a basis for our and other research teams to develop clinic-centered and patient-centered strategies to implement a pragmatic RA trial.
Keywords
Rheumatoid arthritis, physician-perceived patient and clinic barriers, anti-TNF biologic, non-TNF biologic/Janus-Kinase inhibitor, methotrexate
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This is a preprint. It has not completed peer review.
Research article
Identifying Physician-perceived Barriers to Apragmatictreatment Trial Inrheumatoid Arthritis
Jasvinder Singh
University of Alabama at Birmingham
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3485-0006
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 Jun, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Epidemiology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: The aim of this qualitative research was to identify physician-perceived patient and clinic barriers to patient recruitment in a RA pragmatic trial of anti-TNF biologic vs. non-TNF biologic/Janus-Kinase inhibitor initiation after an inadequate response to methotrexate (MTX-IR).
Methods: Semi-structured telephone interviews were conducted with 26 rheumatologists in March 2019. An exploratory thematic analysis approach was used to analyze the interview data.
Results:Physician perceived patient barriers to the implementation ofa RA pragmatic trial. This theme covers three sub-themes: 1) patients’ personal barriers, 2) patients’ treatment-related factors, and 3) trial-related factors (e.g., patient recruitment, side effects, mode of use, etc.). Physicians perceived clinic barriers interfered with the pragmatic trial enrollment from the clinic or the healthcare system perspective. This theme covered four sub-themes: 1) clinic-related factors, 2) patient-related factors, 3) research personnel, and 4) facilitators (positive factors of the clinic).
Conclusions: Our results from the inductive thematic analysis will help researchers understand the key patient and clinic/system factors/barriers that may influence pragmatic RA trial implementation. The themes suggest there are factors that can be modified (e.g., coordinator effort needed, effective patient recruitment during clinic visits, provider engagement) and challenges to overcome (patient insurance status, busy clinic flow, and space issues including limited number of patient rooms). In summary, these themes provide a basis for our and other research teams to develop clinic-centered and patient-centered strategies to implement a pragmatic RA trial.