[How can clinical trials be successfully conducted in primary care settings? - Challenges and solution strategies: a survey of research-active general practices].

BACKGROUND

Patients in general practices are often insufficiently reached for clinical trial participation. Since much care is delivered in the outpatient sector, this sector, particularly general practice, should be central to future research infrastructures. The NAPKON Therapeutic Intervention Platform (NAPKON-TIP), a project of the Network University Medicine, provides infrastructure for clinical trials involving the outpatient sector.

RESEARCH QUESTION: The study aimed to identify barriers to patient recruitment in general practices and strategies to overcome them.

METHODS

From 12/2024 to 02/2025, an online survey assessed recruitment barriers perceived by general practitioners and medical assistants (MFA) in clinical trials. The survey was emailed to DEGAM-ForNet general practice research practices. Reminder emails were used. Questionnaire data were analysed descriptively in SPSS, and free-text responses by qualitative content analysis in MAXQDA.

RESULTS

A total of 62 persons participated; the response rate was 7.2%. Most participants were general practitioners (83.9%); 16.1% were MFA. The most common barriers were high administrative and time burden (88.7%), insufficient remuneration (58.1%), and staff shortages (56.4%). Qualitative content analysis identified barriers in study design, such as complex inclusion criteria; practice-team barriers such as staff shortages; difficult-to-integrate processes in everyday practice; and patient-related difficulties such as being overwhelmed by study demands. Proposed solutions included strengthening practice teams and patients as active research partners in genuine participation, financial and non-material incentives, and simplified digital study logistics.

CONCLUSION

Studies should be adapted to outpatient care needs and planned with existing research practices. This may facilitate study participation for general practices and support a cross-sectoral research infrastructure in which the outpatient sector is equally represented. In this survey, physicians and MFA may have partly worked in the same practice, so participation may not have been evenly distributed across practices.