Clear obstacles and hidden challenges: understanding recruiter perspectives in six pragmatic randomised controlled trials

作者：Jenny Donovan, Sangeetha Paramasivan, Isabel O C de Salis, Merran Toerien · 发表于：Trials · 年份：2014 · DOI：10.1186/1745-6215-15-5 · 被引用次数：266 · 研究领域：Ethics in Clinical Research、Mental Health and Patient Involvement、Meta-analysis and systematic reviews

BACKGROUND: Recruitment of sufficient participants in an efficient manner is still widely acknowledged to be a major challenge to the mounting and completion of randomised controlled trials (RCTs). Few recruitment interventions have involved staff undertaking recruitment. This study aimed i) to understand the recruitment process from the perspective of recruiters actively recruiting RCT participants in six pragmatic RCTs, and ii) to identify opportunities for interventions to improve recruitment. METHODS: Interviews were undertaken with 72 individuals (32 doctors or RCT Chief investigators (CIs); 40 nurses/other health professionals) who were actively recruiting participants in six RCTs to explore their experiences of recruitment. The RCTs varied in scale, duration, and clinical contexts. Interviews were fully transcribed and analysed using qualitative content and thematic analytic methods derived from grounded theory. For this analysis, data were systematically extracted from each RCT and synthesised across all six RCTs to produce a detailed and nuanced understanding of the recruitment process from the perspectives of the recruiters. RESULTS: Recruiters readily identified organisational difficulties, fewer than expected eligible patients, and patients' treatment preferences as the key barriers to recruitment. As they described their experiences of recruitment, several previously hidden issues related to their roles as researchers and clinicians emerged, imbued with discomfor...