Adaptive platform trials for major psychiatric disorder therapeutics: A qualitative acceptability study in the era of precision psychiatry

Background The role of adaptive platform trials (APTs) in improving healthcare is an emerging area of policy discussion. APTs are vital to enhancing current practices by rendering person-centered models to support precision medicine. However, there is a lack of evidence that informs policy and program on its acceptability and barriers to the establishment of APTs in Ethiopia. Objectives To explore the acceptability, perceived benefits, and implementation barriers of establishing APTs for psychiatric care in Ethiopia, drawing on the perspectives of people with psychiatric disorders, healthcare workers, and key policy and regulatory stakeholders. Design An exploratory qualitative study. Methods A qualitative study employing semi-structured in-depth interviews and focus group discussions were conducted among people with psychiatric disorders, healthcare workers, local clinical trial experts and key policy stakeholders. Data were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis, supported by OpenCode version 4.03 software. Results While stakeholders recognized significant infrastructural and regulatory barriers, our findings demonstrated nuanced acceptability. The descriptive data extracted were summarised in to five thematic domains: (I) Patient-centredness, clinical and ethical value of APTs, (II) Institutional trust, transparent governance, and national ownership as foundations for acceptability, (III) Emerging regulatory and infrastructure readiness, (IV) Potential challenges and (V) possible solutions. Conclusion Although perceived as crucial, practical implementation of APT may be constrained by challenging determinants spanned clinical, sociocultural, regulatory, and technical domains. These findings may be useful to facilitate the establishment of APTs and to provide relevant and informative guidance on mitigating identified operational challenges.