Patel Rashmi, Oduola Sherifat, Callard Felicity, Wykes Til, Broadbent Matthew, Stewart Robert, Craig Thomas K J, McGuire Philip
Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
South London and Maudsley NHS Foundation Trust, Biomedical Research Centre Nucleus, Mapother House, London, UK.
BMJ Open. 2017 Mar 9;7(3):e013113. doi: 10.1136/bmjopen-2016-013113.
The proportion of people with mental health disorders who participate in clinical research studies is much smaller than for those with physical health disorders. It is sometimes assumed that this reflects an unwillingness to volunteer for mental health research studies. We examined this issue in a large sample of patients with psychosis.
Cross-sectional study.
Anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM).
5787 adults diagnosed with a psychotic disorder.
Whether approached prior to 1 September 2014 for consent to be approached about research participation.
Number of days spent in a psychiatric hospital, whether admitted to hospital compulsorily, and total score on the Health of the Nation Outcome Scale (HoNOS) between 1 September 2014 and 28 February 2015 with patient factors (age, gender, ethnicity, marital status and diagnosis) and treating clinical service as covariates.
1187 patients (20.5% of the total sample) had been approached about research participation. Of those who were approached, 773 (65.1%) agreed to be contacted in future by researchers. Patients who had been approached had 2.3 fewer inpatient days (95% CI -4.4 to -0.3, p=0.03), were less likely to have had a compulsory admission (OR 0.65, 95% CI 0.50 to 0.84, p=0.001) and had a better HoNOS score (β coefficient -0.9, 95% CI -1.5 to -0.4, p=0.001) than those who had not. Among patients who were approached, there was no significant difference in clinical outcomes between those agreed to research contact and those who did not.
About two-thirds of patients with psychotic disorders were willing to be contacted about participation in research. The patients who were approached had better clinical outcomes than those who were not, suggesting that clinicians were more likely to approach patients who were less unwell.
患有精神健康障碍的人群参与临床研究的比例远低于患有身体健康障碍的人群。有时认为这反映了他们不愿意志愿参与精神健康研究。我们在大量精神分裂症患者样本中研究了这个问题。
横断面研究。
来自南伦敦和莫兹利国民保健服务基金会信托（SLaM）的匿名电子精神健康记录数据。
5787名被诊断患有精神障碍的成年人。
在2014年9月1日前是否被询问是否同意被联系参与研究。
2014年9月1日至2015年2月28日期间在精神病医院住院的天数、是否被强制住院，以及国民健康结局量表（HoNOS）的总分，并将患者因素（年龄、性别、种族、婚姻状况和诊断）及治疗临床服务作为协变量。
1187名患者（占总样本的20.5%）被询问参与研究。在被询问的患者中，773名（65.1%）同意研究人员在未来联系他们。被询问的患者住院天数少2.3天（95%置信区间 -4.4至 -0.3，p = 0.03），被强制住院的可能性较小（比值比0.65，95%置信区间0.50至0.84，p = 0.001），且HoNOS评分更好（β系数 -0.9，95%置信区间 -1.5至 -0.4，p = 0.001），相比未被询问的患者。在被询问的患者中，同意研究联系的患者与不同意的患者在临床结局上无显著差异。
约三分之二的精神障碍患者愿意被联系参与研究。被询问的患者临床结局比未被询问的患者更好，这表明临床医生更倾向于询问病情较轻的患者。
