International survey shows country with lowest healthcare usage and trust correlates to highest likelihood of clinical trial participation.
Quality care in any healthcare system relies heavily on patients developing and maintaining trust in their healthcare professionals (HCPs). As we’ve witnessed throughout the COVID-19 pandemic, local HCPs informing and guiding patients on proper treatment and preventive measures were more successful than similar messages pushed from government agencies or medical institutions.
However, while patient trust in HCPs is essential in delivering proper treatment, trust does not necessarily extend to positive sentiments regarding clinical research.
From May 5 to 7, 2021, SubjectWell polled 892 respondents from South Africa, Canada, and the United States on the topic of healthcare usage, trust, and clinical trial participation. We noticed a noteworthy difference in responses, beginning with how often patients visited their HCPs.
Healthcare usage varied significantly between South Africa, Canada, and the United States.
Respondents were asked how many times in the past two years they’ve seen a doctor, dentist, or other HCP (such as a nurse, nurse practitioner or physician’s assistant) for their own medical treatment. Respondents from South Africa reported significantly fewer visits as compared to those from Canada and the United States. In fact, 70% of respondents from South Africa recorded five or fewer visits to an HCP in the past two years.
Number of visits to an HCP in the past two years:
- South Africa
- United States
11% South Africa vs 3% Canada vs 5% United States
Between one and five visits
59% South Africa vs 33% Canada vs 24% United States
Between six and 10 visits
17% South Africa vs 29% Canada vs 30% United States
More than 11 visits
13% South Africa vs 35% Canada vs 40% United States
Visiting an HCP with any frequency correlated to significantly higher trust levels in the healthcare system.
We then asked respondents how they would rate their trust in the healthcare system, which included hospitals, health insurance companies, and overall medical research. Only 35% of respondents from South Africa rated their trust in the healthcare system as high, compared to 55% and 59% of respondents from the United States and Canada, respectively.
When we look at trust by number of visits to an HCP, those respondents who never visited an HCP in the past two years had the lowest trust in the healthcare system, while those who reported any number of HCP visits stated more trust in the system.
Factoring in the number of HCP visits in the past two years from respondents with high trust in healthcare:
- South Africa
- United States
24% South Africa vs 14% Canada vs 33% United States
One or more visits
38% South Africa vs 60% Canada vs 56% United States
Interestingly, lower healthcare usage and lower trust correlated to higher likelihood of trial participation.
When we took a closer look at the likelihood of clinical trial participation between countries, South Africa, the country with the lowest HCP visitation rates and lowest overall trust in the healthcare system, responded with the highest likelihood of clinical trial participation at 64%.
Percentage of respondents likely to participate in a non-COVID-19 clinical trial:
64% of respondents from South Africa would participate in a clinical trial unrelated to COVID-19
59% of respondents from Canada would participate in a clinical trial unrelated to COVID-19
54% of respondents from the United States would participate in a clinical trial unrelated to COVID-19
Similarly, lower healthcare usage and lower trust correlated to higher confidence in finding a relevant clinical trial.
The survey found a significant difference between countries in their level of confidence in finding a relevant clinical trial, with South Africans rating their confidence levels 20% or higher than confidence rates from the United States and Canada.
Percentage of respondents who demonstrated high confidence in finding a relevant clinical trial:
59% of respondents from South Africa have high confidence in finding a clinical trial
33% of respondents from Canada have high confidence in finding a clinical trial
39% of respondents from the United States have high confidence in finding a relevant clinical trial
Across countries, respondents agreed on where they would seek a clinical trial.
Respondents from South Africa, Canada, and the United States would look first for a clinical trial on Google or Bing, followed by consulting with their doctor, and then online patient communities (social media) as a distant third.
The fourth most common selection, “I don’t know where to find a clinical trial,” was chosen by 13% of respondents, ultimately bringing to light the confusion that remains regarding this alternative treatment path.
Is prevalent distrust in the healthcare system an opportunity for clinical trial recruiting?
Demonstrating a well-documented trend, this survey reflects trust in healthcare systems at disturbingly low levels in all three countries. Yet, the country with the lowest healthcare usage and trust demonstrated a higher likelihood of clinical trial participation and confidence in finding a relevant clinical trial. Which begs the question: do access and quality levels of the healthcare systems in different countries affect clinical research sentiment?
According to the 2021 Health Care Index by Country by Numbeo, which rates the overall quality of international healthcare systems, Canada is ranked 25, the United States ranks 30, and South Africa ranks 48. We could see an increase in participation and confidence in finding a relevant clinical trial solely based on providing treatment for individuals without reliable healthcare.
Recognizing clinical trials as a treatment option, particularly for populations with limited care options or low to no insurance coverage, could provide the best possible results for patients.
To request a download of the complete survey data, visit www.subjectwell.com/surveys. Be sure to check back on our website for more information related to patient recruitment and survey findings.
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