Kaiser Daily Health Policy Report
Coverage & Access | Blacks May Be Less Likely To Enroll in Clinical Trials Because They Mistrust Physicians, Study Finds

[Jan 15, 2008]
http://www.kaisernetwork.org/daily_r...fm?DR_ID=49831

Many black U.S. residents are less likely to participate in clinical studies, possibly because they distrust physicians and have concerns that they could be harmed by the studies, according to a study published online Monday in the journal Medicine, Reuters reports (Dunham, Reuters, 1/14). For the study, lead author Neil Powe, a professor of medicine at Johns Hopkins University, and colleagues surveyed 717 people at 13 outpatient medical clinics in Maryland. Of those people, 460 were white and 257 were black.

The participants were told that the survey was "meant to explore individuals' attitudes about medical research and physicians who perform such research, and reasons for agreeing or declining to participate in clinical trials," according to MedPage Today (Gever, MedPage Today, 1/14).

The study found that blacks were 60% as likely as whites to participate in a mock study of a heart disease drug. Fifty-eight percent of blacks thought their physicians would willingly give them experimental drugs without their consent, compared with 28% of whites, according to the study. In addition, the study found that 25% of blacks said that their physicians would recruit them for risky clinical trials, compared with 15% of whites.

Powe said the distrust results in fewer blacks participating in research, adding, "If we don't test therapies in certain populations, how can we expect to know anything about whether they work in those populations?" (Emery/Kohn, Baltimore Sun, 1/15). According to Powe, blacks might be unwilling to participate in medical studies because of "gross past examples of unethical medical research with ethnic minorities," such as the Tuskegee experiment that began in the 1930s and lasted for about 40 years.

Powe said, "So long as the legacy of Tuskegee persists, African-Americans will be left out of important findings about the latest treatments for diseases, especially those that take a greater toll on African-Americans and consequently may not have ready or equal access to the latest medicines." According to Powe, the mistrust "may be fixable by communicating better with patients and taking actions that improve mutual respect and understanding" (MedPage Today, 1/14).

Clinical Trial Service Providers
In related news, the Indianapolis Star on Tuesday examined efforts by the Indiana-based clinical trial service provider Innovative Clinical Concepts, a company that works to enroll in clinical trials more community-based physicians who treat minorities and underserved populations. A Pharmaceutical Research and Manufacturers of America report released last month found that such efforts are starting to make a difference for hundreds of medications that are being developed to treat major diseases that disproportionately affect blacks or are a major cause of death among blacks (Adams, Indianapolis Star, 1/15).