Barriers and opportunities for clinical trials in Bahrain: a qualitative study of key opinion leaders.

Abstract

Clinical trials are essential for advancing scientific knowledge and improving patient outcomes. In the last decade, Bahrain has made notable progress in healthcare. However, clinical trial participation from the region remains modest. Thus, our study aimed to explore the perspectives of key opinion leaders on the challenges and potential solutions to conducting clinical trials in Bahrain. We conducted an exploratory qualitative study with key opinion leaders involved in clinical trials in Bahrain. Data were analysed using Braun and Clarke's six-step thematic analysis framework. Key opinion leaders were selected using purposive sampling. Academic institutions, governmental hospitals and research institutes in Bahrain. 11 key opinion leaders involved in the planning, oversight, regulation or conduct of clinical trials in Bahrain. We conducted semistructured interviews in English, audio-recorded them and transcribed them verbatim. Data were analysed manually using Braun and Clarke's six-step thematic analysis framework. Five interconnected themes were identified: (1) regulatory and operational barriers, (2) resource and capacity limitations, (3) public engagement and cultural factors, (4) strategic collaboration and systemic improvement and (5) specific research conduct challenges. Key opinion leaders discussed practical context-specific solutions to strengthen the trial ecosystem in Bahrain. Bahrain has a strong national policy and a supportive regulatory framework for clinical research. Despite this, clinical trial output remains modest. Key opinion leaders perceived that persistent structural, operational and cultural challenges continue to limit clinical trial activity in Bahrain. Addressing these challenges through coordinated governance, capacity building, stakeholder collaboration and public engagement may help sustain clinical trials and inform clinical research in similar settings.