Marketing therapeutic precision: Potential facilitators and barriers to adoption of n-of-1 trials
Section snippets
Methods
Our study was approved by the UC Davis and UCLA Institutional Review Boards. The study employed qualitative interview methods to explore and analyze subjects' views of the clinical research enterprise and n-of-1 trials. We recruited purposeful, non-random samples of physicians and patients, aiming to maximize diversity in terms of attitudes about and experience with clinical trials. Pre-established domains of inquiry and topics were used to systematically ask parallel (and in many cases
Participant characteristics
Twenty-one physician participants took part in one of three group interviews (n = 10) or an individual interview (n = 11). Group interviews involved 3–4 physicians and were held by teleconferencing. The 21 physician participants included 14 women and 7 men; 8 were non-white. The average age was 43. About half were general internists; 43% practiced within an academic medical center. Most reported spending at least 4 half-days per week in clinic (Table 1). Thirty-two patients participated in one of
Discussion
Though widely touted as a rigorous approach to individualization of therapy, n-of-1 trials have struggled to gain traction with physicians and patients [16]. We conducted this study to gain insight into perceived benefits and drawbacks of n-of-1 trials from the perspectives of physicians and the public. We learned that most physicians and patients readily grasp the logic of n-of-1 trials and appreciate their potential for personalizing care. However, both groups expressed reservations along
Acknowledgements
This work was funded by Pfizer but conducted, analyzed, and reported independently. Richard L. Kravitz had access to all of the data and takes responsibility for integrity and accuracy. The authors gratefully acknowledge Edward Niedzinski, PhD for his assistance in project management and interviewing, and Phil Raimondi, MD, Malathi Srinivasan, MD, and Andrew Hudnut, MD for help with physician recruiting.
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