Preferences Regarding Clinical Drug Trial Elements: A Nationally Representative Survey of Older Adults With Multimorbidity.

Background: Older adults with multimorbidity have been under-represented in clinical drug trials. We sought to determine willingness to enroll in trials and preferences of older adults for learning about clinical trials, visit frequency, travel, locations, and testing.

Methods: Cross-sectional internet and telephone survey of a nationally representative sample of adults ≥ 65 years with ≥ 3 chronic conditions (NORC University of Chicago Foresight 50+ panel) from March-April 2023 to determine acceptability of aspects of clinical trials.

Results: Surveyed 1318 (1142 Internet, 176 phone), mean age 72.3 ± 6.3 (SD), 52% women; race: 83% White, 10% Black or African American (BLAfrAm), 5% Hispanic or Latino, 1.1% Asian; 4.4 ± 1.9 chronic conditions (of 16 queried), taking 7.5 ± 3.3 medications. Almost half would consider trials of medications for memory problems, hypertension, cancer, chronic pain, diabetes, or high cholesterol. Men and BLAfrAm respondents were the most willing to consider hypertension or diabetes trials. Preferences for where to learn about trials were physician offices (87% overall, 85% of BLAfrAm, 94% of Hispanic); 10% of White respondents considered senior centers versus 30% of BLAfrAm and 20% of Hispanics (p < 0.001). Two-thirds wanted written materials and question and answer sessions (no significant sex or racial differences). Respondents anticipated no difficulty with measuring blood pressure at home, and only respondents > 80 years anticipated difficulty wearing activity monitoring devices. All groups preferred monthly or every 3-4 month visits for physical exams, blood or urine tests vs. less frequently and were willing to travel half an hour in each direction for visits.

Conclusions: Efforts to increase enrollment of older adults and older adults from previously under-represented racial populations will need increased physician engagement. Pragmatic trials with infrequent participant contact are not likely to increase participation of older adults with multimorbidity.