Motivation and barriers to participation in clinical trials

Background: Clinical trials are essential in clinically orientated medical research. Enrollment of patients is determined by patient-related barriers, protocol-related barriers, and motivation and behavior of the physician. Main Theses: Patients enrollment in clinical trials is determined by disease, possible diagnostic or therapeutic benefit of study procedures, effort of protocol procedures, and trustfulness of the relationship between the physician and patient. Randomized trials, extensive study procedures and the possibility of receiving placebo are barriers to participation. Understanding of the communication process and knowledge of patients' needs are the base education to gain patients' informed consent to enter a clinical trial and a stable compliance in the course of the study. Motivation of physicians to enroll patients in a clinical trial is determined, e.g., by environmental conditions in clinic or doctors' office, the time and effort of study procedures, and individual academic interest. Conclusion: Awareness of factors (positive and negative) which influence motivation of participation in a clinical trial is useful to provide strategies for successful enrollment of patients.