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Factors affecting recruitment to an observational multicentre palliative care study.

Stone PC, Gwilliam B, Keeley V, Todd C, Kelly LC, Barclay S - BMJ Support Palliat Care (2013)

Bottom Line: Of the 2410 patients who were visited by the research team and asked to participate in the study 1378 (57%) declined.Overall 8.2% (1018/12 412) of patients screened participated in the study.There were significant differences in recruitment patterns between hospice inpatient units, hospital support and community palliative care teams.

View Article: PubMed Central - PubMed

Affiliation: Division of Population, Health Sciences and Education, St George's University of London, Cranmer Terrace, London, UK.

ABSTRACT

Objectives: To identify those factors which adversely affected recruitment to a large multicentre palliative care study.

Methods: Patient accrual to a multicentre, observational, palliative care study was monitored at three critical junctures in the research process. (1) Eligibility-did the patient fulfil the study entry criteria? (2) Accessibility-was it possible to access the patient to be able to inform them about the study? (3) Consent-did the patient agree to participate in the study? The reasons why patients were ineligible, inaccessible or refused consent were recorded.

Results: 12 412 consecutive referrals to participating clinical services were screened for study inclusion of whom 5394 (43%) were deemed to be ineligible. Of the remaining patients 4617/7018 (66%) were inaccessible to the research team. The most common reasons being precipitous death, 'gatekeeping' by clinical staff or rapid discharge. Of the 2410 patients who were visited by the research team and asked to participate in the study 1378 (57%) declined. Overall 8.2% (1018/12 412) of patients screened participated in the study. There were significant differences in recruitment patterns between hospice inpatient units, hospital support and community palliative care teams.

Conclusions: Systematic monitoring and analysis of patient flows through the clinical trial accrual process provided valuable insights about the reasons for failure to recruit patients to a clinical trial and may help to improve recruitment in future studies.

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CONSORT diagram to show recruitment to the Prognosis in Palliative care Study (PiPS) study.
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BMJSPCARE2012000396F1: CONSORT diagram to show recruitment to the Prognosis in Palliative care Study (PiPS) study.

Mentions: Between March 2006 and August 2009, 12 412 patients were screened for eligibility for PiPS (hospices n=4593; hospitals n=4696; community teams n=3123). Of these patients only 1018/12 412 (8%) subjects were actually recruited to the study. Figure 1 shows the flow of patients through the recruitment process and the attrition at each of the three key bottlenecks. Of the 12 412 patients screened, 7018 (57%) were eligible for inclusion, 2401/7018 (34%) of those patients were accessed by the research team and of those 1023/2401 (43%) were subsequently recruited to the study.


Factors affecting recruitment to an observational multicentre palliative care study.

Stone PC, Gwilliam B, Keeley V, Todd C, Kelly LC, Barclay S - BMJ Support Palliat Care (2013)

CONSORT diagram to show recruitment to the Prognosis in Palliative care Study (PiPS) study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756458&req=5

BMJSPCARE2012000396F1: CONSORT diagram to show recruitment to the Prognosis in Palliative care Study (PiPS) study.
Mentions: Between March 2006 and August 2009, 12 412 patients were screened for eligibility for PiPS (hospices n=4593; hospitals n=4696; community teams n=3123). Of these patients only 1018/12 412 (8%) subjects were actually recruited to the study. Figure 1 shows the flow of patients through the recruitment process and the attrition at each of the three key bottlenecks. Of the 12 412 patients screened, 7018 (57%) were eligible for inclusion, 2401/7018 (34%) of those patients were accessed by the research team and of those 1023/2401 (43%) were subsequently recruited to the study.

Bottom Line: Of the 2410 patients who were visited by the research team and asked to participate in the study 1378 (57%) declined.Overall 8.2% (1018/12 412) of patients screened participated in the study.There were significant differences in recruitment patterns between hospice inpatient units, hospital support and community palliative care teams.

View Article: PubMed Central - PubMed

Affiliation: Division of Population, Health Sciences and Education, St George's University of London, Cranmer Terrace, London, UK.

ABSTRACT

Objectives: To identify those factors which adversely affected recruitment to a large multicentre palliative care study.

Methods: Patient accrual to a multicentre, observational, palliative care study was monitored at three critical junctures in the research process. (1) Eligibility-did the patient fulfil the study entry criteria? (2) Accessibility-was it possible to access the patient to be able to inform them about the study? (3) Consent-did the patient agree to participate in the study? The reasons why patients were ineligible, inaccessible or refused consent were recorded.

Results: 12 412 consecutive referrals to participating clinical services were screened for study inclusion of whom 5394 (43%) were deemed to be ineligible. Of the remaining patients 4617/7018 (66%) were inaccessible to the research team. The most common reasons being precipitous death, 'gatekeeping' by clinical staff or rapid discharge. Of the 2410 patients who were visited by the research team and asked to participate in the study 1378 (57%) declined. Overall 8.2% (1018/12 412) of patients screened participated in the study. There were significant differences in recruitment patterns between hospice inpatient units, hospital support and community palliative care teams.

Conclusions: Systematic monitoring and analysis of patient flows through the clinical trial accrual process provided valuable insights about the reasons for failure to recruit patients to a clinical trial and may help to improve recruitment in future studies.

Show MeSH