Purpose: Clinical trials are the primary means for de-termining new, effective treatments for cancer patients, yet the number of patients that accrue is relatively limited. The purpose of this study was to explore the relationship between physician behavior and patient accrual to a clinical trial by videotaping the interaction. Patients and Methods: Forty-eight patient-physician interactions involving 12 different oncologists were vid-eotaped in several clinics at the H. Lee Moffitt Cancer Center and Research Institute (Tampa, FL). The purpose of each interaction was to present the possibility of a clinical trial to the patient. A coding system, the Moffitt Accrual Analysis System, was developed by the authors to code behaviors that represented both the legal-informational and social influence models of communi-cation behavior. Thirty-two patients agreed to partici-pate in the clinical trial. Results: Videotaping was found to be a viable, valid, and reliable method for studying the interaction. Physi-cians who were observed to use both models of influ-ence were found to enroll more patients. Thus, patients were more likely to accrue to the trial when their physician verbally presented items normally included in an informed consent document and when they behaved in a reflective, patient-centered, supportive, and respon-sive manner. Discussion of benefits, side effects, patient concerns and resources to manage the concerns were all associated with accrual. Conclusion: This research has implications for modi-fying physician behavior and, thus, increasing the num-bers of patients accruing to oncology clinical trials.
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