Attitudes on participation in clinical drug trials: A nationally representative survey of older adults with multimorbidity.

BACKGROUND: Older adults with multimorbidity are under-represented in clinical drug trials. Their inclusion will not increase unless they are willing and able to participate. Data on motivators and barriers to participation in trials of new medications of older adults with multimorbidity are needed. METHODS: Cross-sectional internet and telephone survey of a nationally representative sample of adults ≥65 years with ≥3 chronic conditions (NORC University of Chicago Amerispeak Panel) conducted from March-April, 2023 to determine motivators and barriers to drug trial participation, described graphically and using statistics. RESULTS: Surveyed 1318 (1142 Internet, 176 phone) with mean age 72.3 ± 6.3 (SD), 52% women; race: 83% White, 10% Black or African American, 5% Hispanic or Latino, 1.1% Asian; 4.4 ± 1.9 chronic conditions (of 16 queried), taking 7.5 ± 3.3 medications. Barriers included fear of side effects (48%), taking too many medications (44%), placebo (44%), mobility (33%), bathroom needs (25%), hearing (19%), eyesight (15%), video visits (33%; higher in women, Black or African-American respondents, and those ≥80 years). Sixty-five percent would join all in-person trials, 49% would join all-video trials. Travel >1 h was difficult for 66%, most difficult for women. Trust was a concern in 25% of Black respondents. Caregiving responsibilities or lack of time were not obstacles. Participants were most likely to consider a drug trial for a problem they have (63%) versus prevention (44%) and if invited by a physician (80%) or University healthcare system (58%). Getting better care was ranked very important (79%) followed by helping others (57%). CONCLUSIONS: Major concerns of older patients with multimorbidity about participation in drug trials are potential side effects, taking too many medicines, and video visits. Physicians have the greatest influence on decisions and in-person visits are preferred. Proposed changes in trial design to increase enrollment of under-represented older adults may not align with patient-reported preferences.

Software reuse reference model approach in developing an automated medical information system (AMIS) for improving health care practice.

OBJECTIVE: To evaluate patient acceptance of an automated medical information system specific to headache. BACKGROUND: Studies suggest that automated tools may help health care delivery systems to be efficient and effective, but patient satisfaction remains a major concern. METHODS: We adapted our software reuse reference model and Unified Modeling Language to apply the domain model to the headache population. Patients with headache were tested both to validate the system and to evaluate patient satisfaction and headache management with an automated system. RESULTS: The mean age of all study participants was 44 years. Over 95% of the participants were satisfied or strongly satisfied with the Automated Medical Information System. CONCLUSIONS: The results strongly suggest that patients are willing and able to use nontraditional sources, such as the Automated Medical Information System, to learn about their illnesses.