Journal of General Internal Medicine

, Volume 17, Issue 9, pp 689–695 | Cite as

Physicians’ preferences for active-controlled versus placebo-controlled trials of new antihypertensive drugs

  • Scott D. Halpern
  • Peter A. Ubel
  • Jesse A. Berlin
  • Raymond R. Townsend
  • David A. Asch
Original Articles


OBJECTIVE: To evaluate physicians’ preferences for referring patients to, and using information from, active-controlled trials (ACTs) versus placebo-controlled trials (PCTs) of new antihypertensive drugs.

DESIGN AND SETTING: Nationwide mailed survey, with telephone contact of nonresponders to assess nonresponse bias.

PARTICIPANTS: One thousand two hundred primary care physicians randomly selected from the American Medical Association’s Master File. Of 1,154 physicians eligible to respond, 651 (56.4%) returned completed questionnaires.

MEASUREMENTS AND MAIN RESULTS: We measured physicians’ stated willingness to encourage hypertensive patients to enroll in ACTs and PCTs of new antihypertensive drugs, their views of the relative merits of ACTs versus PCTs, their stated willingness to prescribe new drugs tested in ACTs or PCTs, and their views regarding the overall justifiability of the 2 designs. Physicians were significantly more likely to indicate they would encourage their patients to enroll in ACTs than in PCTs (P<.0001). Physicians thought ACTs provided more valuable information for their practices, were more likely to lead to a public health benefit, offered enrolled patients greater opportunity for personal benefit, and were less likely to expose enrolled patients to unnecessary risks (all P<.0001). Physicians were more likely to prescribe new drugs that had been compared in ACTs (P<.0001), and viewed ACTs as a more justifiable method for testing new antihypertensive drugs (P<.0001). There was no evidence of nonresponse bias for these main results.

CONCLUSIONS: Although PCTs remain the standard method for testing new antihypertensive drugs, physicians strongly prefer ACTs. Using ACTs to test new antihypertensive drugs may enhance the efficiency of patient recruitment and more strongly influence physicians’ prescribing practices.

Key words

clinical trials placebo-controlled trials antihypertensive drugs physicians’ preferences ethics 


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Copyright information

© Society of General Internal Medicine 2002

Authors and Affiliations

  • Scott D. Halpern
    • 7
    • 1
    • 2
  • Peter A. Ubel
    • 8
    • 5
    • 6
  • Jesse A. Berlin
    • 7
    • 2
  • Raymond R. Townsend
    • 3
  • David A. Asch
    • 7
    • 1
    • 8
    • 4
  1. 1.Center for BioethicsUSA
  2. 2.Center for Education and Research on TherapeuticsUSA
  3. 3.Department of MedicineUniversity of Pennsylvania School of MedicineUSA
  4. 4.the Center for Health Equity Research and PromotionPhiladelphia Veterans Affairs Medical CenterPhiladelphia
  5. 5.Ann Arbor Veterans Affairs Medical CenterUniversity of Michigan School of MedicineAnn Arbor
  6. 6.Division of General Internal MedicineUniversity of Michigan School of MedicineAnn Arbor
  7. 7.Center for Clinical Epidemiology and BiostatisticsPhiladelphia
  8. 8.Leonard Davis Institute of Health EconomicsPhiladelphia

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