Trust in research physicians as a key dimension of randomized controlled trial participation in clinical addictions research

Abstract

Background: In the development of pharmacotherapies for substance use disorders, willingness to participate in randomized controlled trials (RCTs) among people who use drugs (PWUD) is influenced by numerous social and structural factors. Considering the criminalization and stigma experienced by PWUD and range of experiences in healthcare and research, PWUD may vary in their trust of health providers, health research physicians, or medical research processes. We therefore examine associations between trust in these three domains and willingness to participate in a hypothetical RCT for a novel pharmacotherapy for stimulant use among PWUD. Methods: Data were derived from a cross-sectional questionnaire administered to participants using crack and/or cocaine from three cohort studies of PWUD in Vancouver (N = 229). Results: A majority of participants were “definitely” or “probably” willing to participate in an RCT. In multivariable ordinal regression, trust in research physicians was positively associated with willingness to participate, while trust in primary care providers or medical research processes were not significantly associated. Conclusions: This data suggests trust in research physicians plays a role in RCT decision-making among PWUD, while trust in healthcare providers and research processes appears less relevant. These findings highlight opportunities for supporting RCT recruitment by building trust in research physicians.

Keywords:

• Substance use disorders
• stimulants
• trust
• research subjects
• randomized controlled trials

Acknowledgements

The authors thank the study participants for their contribution to the research, as well as current and past researchers and staff, and Richard Carpiano for feedback on earlier drafts of the manuscript.

Ethics approval

VIDUS, ACCESS, and ARYS and the supplement have received ethics approval from Providence Health Care/University of British Columbia’s Research Ethics Board.

Author contributions

Conceptualization (KJ, LR); Writing—original draft (KJ); Writing—review & editing (KJ, EN, LR, MJM, KH, KD); Formal analysis (EN); Data curation (EN); Investigation (LR, KD, KH, MJM); Resources (LR, KD, KH, MJM); Funding acquisition (LR, KD, KH, MJM); Supervision (LR); Project administration (LR).

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

Study data collection was supported by the Canadian Institutes of Health Research [MOP-137068, FDN-154320, MOP-102742] as well as the US National Institutes of Health [U01DA038886, U01DA021525]. In addition, LR, MJM and KH are supported by a Michael Smith Foundation for Health Research (MSFHR) Career Scholar Awards and CIHR New Investigator Awards [MSH 217672, MSH 141971, MSH 360816]. KD is supported by a MSFHR/St. Paul’s Hospital Foundation–Providence Health Care Career Scholar Award; and a CIHR New Investigator Award [MSH 136646]. LR’s research is additionally supported by a CIHR Foundation Grant [FDN-154320]. MJM is also supported by the US National Institutes of Health [U01-DA0251525]. KH also holds the St. Paul’s Hospital Chair in Substance Use Research and is supported by the St. Paul’s Foundation. KJ is supported by a Vanier Canada Graduate Scholarship from CIHR and UBC Public Scholars Initiative and the Center for Applied Ethics. Funders had no role in the writing or submission of this manuscript.