Mudano Amy S, Gary Lisa C, Oliveira Ana L, Melton Mary, Wright Nicole C, Curtis Jeffrey R, Delzell Elizabeth, Harrington T Michael, Kilgore Meredith L, Lewis Cora Elizabeth, Singh Jasvinder A, Warriner Amy H, Pace Wilson D, Saag Kenneth G
Center for Education and Research on Therapeutics (CERTs) ; Center for Outcomes Effectiveness Research and Education (COERE), (University of Alabama at Birmingham, Birmingham, AL, USA) ; Center for Clinical and Translational Sciences (CCTS), (University of Alabama at Birmingham, Birmingham, AL, USA).
Patient Prefer Adherence. 2013 Jun 14;7:517-23. doi: 10.2147/PPA.S44551. Print 2013.
Pragmatic clinical trials (PCTs) provide large sample sizes and enhanced generalizability to assess therapeutic effectiveness, but efficient patient enrollment procedures are a challenge, especially for community physicians. Advances in technology may improve methods of patient recruitment and screening in PCTs. Our study looked at a tablet computer versus an integrated voice response system (IVRS) for patient recruitment and screening for an osteoporosis PCT in community physician offices.
We recruited women ≥ 65 years of age from community physician offices to answer screening questions for a hypothetical osteoporosis active comparator PCT using a tablet computer or IVRS. We assessed the feasibility of these technologies for patient recruitment as well as for patient, physician, and office staff satisfaction with the process. We also evaluated the implications of these novel recruitment processes in determining the number of primary care practices and screened patients needed to conduct the proposed trial.
A total of 160 women (80% of those approached) agreed to complete the osteoporosis screening questions in ten family physicians' offices. Women using the tablet computer were able to complete all screening questions consistently and showed a nonsignificant trend towards greater ease of use and willingness to spend more time in their physician's office compared to those using IVRS. Using the proportion of women found to be eligible in this study (almost 20%) and other eligibility scenarios, we determined that between 240 and 670 community physician offices would be needed to recruit ample patients for our hypothetical study.
We found good satisfaction and feasibility with a tablet computer interface for the recruitment and screening of patients for a hypothetical osteoporosis PCT in community office settings. In addition, we used this experience to estimate the number of research sites needed for such a study.
实用性临床试验(PCTs)提供了大样本量并增强了评估治疗效果的可推广性,但高效的患者招募程序是一项挑战,尤其是对于社区医生而言。技术进步可能会改善PCTs中患者招募和筛查的方法。我们的研究比较了在社区医生办公室中使用平板电脑与集成语音应答系统(IVRS)进行骨质疏松症PCT的患者招募和筛查情况。
我们从社区医生办公室招募65岁及以上的女性,使用平板电脑或IVRS回答一项假设的骨质疏松症活性对照PCT的筛查问题。我们评估了这些技术用于患者招募的可行性,以及患者、医生和办公室工作人员对该过程的满意度。我们还评估了这些新型招募流程对确定开展拟议试验所需的基层医疗实践数量和筛查患者数量的影响。
共有160名女性(占接触者的80%)同意在十家家庭医生办公室完成骨质疏松症筛查问题。与使用IVRS的女性相比,使用平板电脑的女性能够始终如一地完成所有筛查问题,并且在易用性和愿意在医生办公室花费更多时间方面呈现出不显著的趋势。利用本研究中发现符合条件的女性比例(近20%)和其他符合条件的情况,我们确定需要240至670家社区医生办公室才能为我们的假设研究招募到足够的患者。
我们发现在社区办公室环境中,使用平板电脑界面进行假设的骨质疏松症PCT患者招募和筛查具有良好的满意度和可行性。此外,我们利用这一经验估计了此类研究所需的研究地点数量。