A nudge toward participation: Improving clinical trial enrollment with behavioral economics
Eric M. VanEpps, Kevin G. Volpp and Scott D. Halpern (University of Pennsylvania)
Science Translational Medicine – 20 Jul 2016
Vol. 8, Issue 348, pp. 348fs13
Interventions informed by behavioral economics can address barriers to patient enrollment in clinical trials and improve recruitment efforts.
Participant recruitment represents one of the largest costs of conducting randomized controlled trials (RCTs), and barriers to recruitment can generate problems of selective enrollment and under-enrollment. These problems have long plagued efforts to evaluate medical interventions by limiting generalizability and reducing statistical power. In recent decades, behavioral economics has provided considerable insights into how people make decisions, blending findings from economics and psychology to generate better descriptive and normative models of behavior. Systematic efforts to apply this approach to problems such as patient enrollment in RCTs have not been attempted. In this article, we provide a taxonomy of proposed interventions (Table 1) informed by behavioral economic theory to address low enrollment in clinical trials by addressing the patient barriers of imperfect information, desire for autonomy in making enrollment decisions, and resource constraints. This taxonomy is not exhaustive, but it provides a range of behaviorally informed interventions, or “nudges,” that might feasibly be tested and, if successful, implemented.
> Check also Experientia’s own whitepaper on the topic: “Conducting clinical trials is about working with patients“