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以患者为中心的随机对照研究的招募与保留

Patient-centered recruitment and retention for a randomized controlled study.

作者信息

Chhatre Sumedha, Jefferson Ashlie, Cook Ratna, Meeker Caitlin R, Kim Ji Hyun, Hartz Kayla Marie, Wong Yu-Ning, Caruso Adele, Newman Diane K, Morales Knashawn H, Jayadevappa Ravishankar

机构信息

Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St. Suite 4051, Philadelphia, PA, 19104, USA.

Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Trials. 2018 Mar 27;19(1):205. doi: 10.1186/s13063-018-2578-7.

Abstract

BACKGROUND

Recruitment and retention strategies for patient-centered outcomes research are evolving and research on the subject is limited. In this work, we present a conceptual model of patient-centered recruitment and retention, and describe the recruitment and retention activities and related challenges in a patient-centered comparative effectiveness trial.

METHODS

This is a multicenter, longitudinal randomized controlled trial in localized prostate cancer patients.

RESULTS

We recruited 743 participants from three sites over 15 months period (January 2014 to March 2015), and followed them for 24 months. At site 1, of the 773 eligible participants, 551 (72%) were enrolled. At site 2, 34 participants were eligible and 23 (68%) enrolled. Of the 434 eligible participants at site 3, 169 (39%) enrolled. We observed that strategies related to the concepts of trust (e.g., physician involvement, ensuring protection of information), communication (e.g., brochures and pamphlets in physicians' offices, continued contact during regular clinic visits and calling/emailing assessment), attitude (e.g., emphasizing the altruistic value of research, positive attitude of providers and research staff), and expectations (e.g., full disclosure of study requirements and time commitment, update letters) facilitated successful patient recruitment and retention. A stakeholders' advisory board provided important input for the recruitment and retention activities. Active engagement, reminders at the offices, and personalized update letters helped retention during follow-up. Usefulness of telephone recruitment was site specific and, at one site, the time requirement for telephone recruitment was a challenge.

CONCLUSIONS

We have presented multilevel strategies for successful recruitment and retention in a clinical trial using a patient-centered approach. Our strategies were flexible to accommodate site-level requirements. These strategies as well as the challenges can aid recruitment and retention efforts of future large-scale, patient-centered research studies.

TRIAL REGISTRATION

Clinicaltrials.gov , ID: NCT02032550 . Registered on 22 November 2013.

摘要

背景

以患者为中心的疗效研究的招募与保留策略正在不断发展,而关于这一主题的研究有限。在本研究中,我们提出了一个以患者为中心的招募与保留概念模型,并描述了一项以患者为中心的比较疗效试验中的招募与保留活动及相关挑战。

方法

这是一项针对局限性前列腺癌患者的多中心纵向随机对照试验。

结果

在15个月期间(2014年1月至2015年3月),我们从三个地点招募了743名参与者,并对他们进行了24个月的随访。在地点1,773名符合条件的参与者中有551名(72%)被纳入研究。在地点2,34名参与者符合条件,23名(68%)被纳入。在地点3的434名符合条件的参与者中,169名(39%)被纳入。我们观察到,与信任概念(如医生参与、确保信息保护)、沟通(如医生办公室的宣传册和小册子、定期门诊期间的持续联系以及致电/发送电子邮件进行评估)、态度(如强调研究的利他价值、提供者和研究人员的积极态度)和期望(如充分披露研究要求和时间投入、更新信件)相关的策略有助于成功招募和保留患者。一个利益相关者咨询委员会为招募和保留活动提供了重要意见。积极参与、在办公室提醒以及个性化更新信件有助于随访期间的保留。电话招募的有效性因地点而异,在一个地点,电话招募的时间要求是一个挑战。

结论

我们提出了在以患者为中心的临床试验中成功招募和保留患者的多层次策略。我们的策略具有灵活性,可适应地点层面的要求。这些策略以及挑战有助于未来大规模、以患者为中心的研究的招募和保留工作。

试验注册

Clinicaltrials.gov,标识符:NCT02032550。于2013年11月22日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77a2/5870194/a9a7c385ee8c/13063_2018_2578_Fig1_HTML.jpg

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