For the lay public, clinical research is not typically a topic of dinner table conversation. It's not discussed in high school
science classrooms. And it's usually only discussed in a doctor's office when a patient has been diagnosed with an illness
for which no available treatment exists or for which available treatments are unpleasant, unsafe, and ineffective.
Yet arguably, clinical research touches every person's life regularly. According to the U.S. Census Bureau, more than half
of all Americans (55%) are taking prescription medications at the present time. Most Americans (90%) report routinely using
over-the-counter medications. And most Americans (85%) state that they recently read an article or heard press coverage of
clinical studies recommending new approaches to improving health through diet, exercise, and lifestyle changes.
The lay public simply does not realize or understand that all medicines it consumes—and many behavioral interventions—have
gone through clinical testing, involving people who have volunteered their participation. Indeed, although the majority of
people believe that clinical research helps advance medical knowledge, less than 15% believe they have even a rudimentary
understanding of how clinical research affects them directly.
This public service ad for CISCRP was rated highly among focus group members, beating out campaigns featuring sports stars.
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Ubiquitous patient recruitment ads on metro trains, in big-city newspapers, on the radio, and in health communications bombard
the public frequently. An estimated half a billion dollars is spent annually on mass media patient recruitment advertising
and promotion. These ads are designed to recruit for specific studies, and yet it is clear that the broader understanding
of the benefit of clinical research is neither widely considered nor appreciated by the public. For this reason, specific
study messages are met with a large amount of indifference: They have no foundation on which to rest. The public has no context
within which to understand the importance of clinical research.
Extensive media coverage of drug withdrawals and their aftermath; conflicts-of-interest among FDA members and research professionals;
questionable pricing practices; and tragic errors resulting in harm to patients have left the public confused and troubled.
Public sentiment toward the clinical research enterprise is at an all time low. One recent public poll revealed that only
14% of the American public feels pharmaceutical companies are "Honest," a rating similar to that bestowed upon the tobacco
and used car industries. In another 2006 poll, more than 70% of Americans said they believe drug companies put profits ahead
of patient needs.
The clinical research enterprise faces its greatest crisis ever: widespread distrust. Without public and patient support,
there can be no realization of innovations in medical therapies. In the absence of study volunteers, clinical trials cannot
be conducted or they are severely delayed and, ultimately, public health advances are not made. An alarmingly low 4% to 6%
of eligible patients participate in U.S.-based clinical trials annually.
The clinical research community has largely failed to respond to poor public perception and eroding public trust. Professionals
affiliated with research sponsor organizations, with service providers, educators, regulatory agencies, and human subject
protection programs have been insular in their approaches to addressing the crisis. They have focused on better professional
training, on accreditation and certification, and on improving the disclosure of conflicts-of-interest and the accessibility
of clinical research information. But the magnitude of this crisis demands a response designed to educate the lay public and
to "rebrand" clinical research as a valuable public good.
