Stakeholders' views on the routine use of n-of-1 trials to improve clinical care and to make resource allocation decisions for drug use

Jane Nikles, Geoffrey K. Mitchell, Alexandra Clavarino, Michael J. Yelland, Christopher B. Del Mar

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6 Citations (Scopus)

Abstract

N-of-1 trials are empirical formal tests using a within-patient randomised, double-blind, cross-over comparison of drug and placebo (or another drug), which we adapted to study individual patients' responses as a clinical tool to guide clinical management. We administered semi-structured interviews to gauge stakeholder perspectives on the possibility of using routine n-of-1 trials for this purpose. Stakeholders included government and non-government health care sector, and patient, clinician and consumer, organisations. Stakeholders supported more widespread implementation of n-of-1 trials, in a targeted fashion, with some caveats. Barriers to their widespread implementation included constraints on doctors' time, doctors' acceptance, drug company acceptance, patient willingness, and cost. Strategies for overcoming barriers included conditional Pharmaceutical Benefits Scheme listing if cost-effective. There was little consensus on which model of n-of-1 trial implementation would be most effective. We discuss different approaches to addressing the several concerns raised to enable widespread introduction of n-of-1 trials into routine clinical practice as a decision tool.

Original languageEnglish
Pages (from-to)131-136
Number of pages6
JournalAustralian Health Review
Volume34
Issue number1
DOIs
Publication statusPublished - 2010

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Resource Allocation
Pharmaceutical Preparations
Consumer Organizations
Costs and Cost Analysis
Health Care Sector
Placebos
Interviews

Cite this

Nikles, Jane ; Mitchell, Geoffrey K. ; Clavarino, Alexandra ; Yelland, Michael J. ; Del Mar, Christopher B. / Stakeholders' views on the routine use of n-of-1 trials to improve clinical care and to make resource allocation decisions for drug use. In: Australian Health Review. 2010 ; Vol. 34, No. 1. pp. 131-136.
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Stakeholders' views on the routine use of n-of-1 trials to improve clinical care and to make resource allocation decisions for drug use. / Nikles, Jane; Mitchell, Geoffrey K.; Clavarino, Alexandra; Yelland, Michael J.; Del Mar, Christopher B.

In: Australian Health Review, Vol. 34, No. 1, 2010, p. 131-136.

Research output: Contribution to journalArticleResearchpeer-review

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