Patient and Clinician Treatment Priorities Differ Greatly From Researchers'

There is an important mismatch existing between the types of treatments proposed by patients and clinicians and those being researched, according to a study published in Research Involvement and Engagement.

Although the mismatch between clinicians’ and patients’ priorities and researchers’ was first identified 15 years ago, British researchers studying treatment research priorities generated by Priority Setting Partnerships (PSPs) at the James Lind Alliance determined there is still a marked difference.

Lead author Sally Crowe and colleagues assembled priority lists from all the PSPs, totaling 149 priorities in a diverse array of health problems, including asthma, prostate cancer, type 1 diabetes, life after stroke, tinnitus, lyme disease, and pressure ulcers. They then compared the prioritized treatments with those being studied in samples of clinical trials done over the same period of time.

“If research is to reflect the priorities of patients and clinicians, leadership and incentives will be needed,” the authors wrote. “The current research ‘system’ and culture is not geared to bridging the mismatch we have documented.”

On average, drug trials are preferred by researchers, while patients, carers, and clinicians showed a preference for non-drug treatments. Drugs accounted for only 18% of treatments mentioned in priorities for the PSPs, while they accounted for 37% in registered non-commercial trials and 86% in registered commercial trials.

While the researchers were unsurprised that such a high proportion of registered commercial trials concerned the evaluation of drugs, they through it was noteworthy that only 2.6% of these trials studied the effects of non-drug treatments that patients and clinicians rate as being important.

“[The finding] suggests that few of these drug trials can have used non-drug comparators, for example, comparing drugs with psychological therapies for treating depression,” the authors wrote.