Barriers to Enrollment to Clinical Trials

Enrolling participants in clinical trials poses numerous challenges, with several barriers hindering the recruitment process. A lack of awareness and understanding regarding clinical trials among potential participants, coupled with concerns about potential risks and side effects, often contributes to hesitancy. Additionally, logistical barriers such as geographical constraints, limited access to healthcare information, and stringent eligibility criteria further impede the successful enrollment of diverse and representative cohorts in clinical research studies. Overcoming these barriers is essential for ensuring the inclusivity and effectiveness of clinical trials in advancing medical knowledge and improving patient care.

    • Lack of awareness or understanding about clinical trials – some people may not know that clinical trials are an option or may not understand what they involve.
    • Fear of the unknown – some people may be hesitant to participate in a clinical trial because they are unsure what to expect or are concerned about the potential risks.
    • Lack of trust – some people may not trust the medical system or pharmaceutical companies and may be hesitant to participate in a clinical trial.
    • Transportation and geographic barriers – some people may not be able to participate in a clinical trial because the trial is too far away or they lack the means of transportation to get to a trial site.
    • Financial barriers – some people may not be able to participate in a clinical trial because they do not speak the language used in the trial or they have difficulty understanding the informed consent document.
    • Eligibility criteria – some people may not be eligible to participate in a clinical trial because they do not meet the inclusion criteria, such as having a specific medical condition.
    • Timing – some people may not be able to participate in a clinical trial because they are not available when it is taking place.
    • Personal circumstances – some people may not be able to participate in a clinical trial due to personal circumstances such as childcare or elder care responsibilities.

(Barre et al., 2022, Abu-Farha et al., 2020, https://orwh.od.nih.gov/sites/orwh/files/docs/orwh_outreach_toolkit_litreview.pdf, Review of the Literature: Primary Barriers and Facilitators to Participation in Clinical Research (nih.gov), Rodriguez-Torres et al., 2021,