O'Hare Fleur, Spark Simone, Flanagan Zachary, Heritier Stephane, Curtis Andrea, Zoungas Sophia
Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia.
Contemp Clin Trials Commun. 2018 Jun 12;11:89-94. doi: 10.1016/j.conctc.2018.05.003. eCollection 2018 Sep.
To compare recruitment, refusal and randomisation rates of older adults into a general practice-based clinical trial with two versions (varied format, content and language) of the Participant Information and Consent Form (PICF).
This prospective PICF study was conducted within the STAREE (STAtins in Reducing Events in the Elderly) clinical trial. Participants phone screened between October 2015 to February 2016 formed Group 1 and were mailed the extended PICF version and participants phone screened between October 2016 to February 2017 formed Group 2 and were mailed the shortened PICF version. Participants who attended a subsequent baseline screening visit were guided through a comprehensive informed consent process.
During the screening phase of the trial, the likelihood of refusing trial participation was lower in Group 2 compared to Group 1 equating to an overall 23% reduction in risk (RR 0.77, P = 0.005, 95% CI 0.62-0.95). Group 2 had a 6.4% higher randomisation rate compared with Group 1 (65.3% versus 58.9% respectively) but this difference was not statistically significant. Factors associated with trial participation were male gender, age between 70 and 75 years and living alone (all p < .0.05).
Whilst avoiding lengthy and complex PICF documents may assist with initial trial engagement, it needs to be supplemented with other strategies to support ongoing trial interest to randomisation and beyond. Participants refused trial participation throughout the screening phase indicating that the PICF was only one factor among several affecting an individual's decision to participate in this clinical trial.
比较老年人参与一项基于全科医疗的临床试验的招募、拒绝和随机分组率,该试验使用了两种版本(格式、内容和语言不同)的参与者信息和同意书(PICF)。
这项前瞻性PICF研究在STAREE(老年患者他汀类药物降低事件风险)临床试验中进行。2015年10月至2016年2月通过电话筛选的参与者组成第1组,被邮寄扩展版PICF;2016年10月至2017年2月通过电话筛选的参与者组成第2组,被邮寄缩短版PICF。参加后续基线筛查访视的参与者接受了全面的知情同意过程指导。
在试验的筛查阶段,第2组拒绝参与试验的可能性低于第1组,相当于总体风险降低23%(风险比0.77,P = 0.005,95%置信区间0.62 - 0.95)。第2组的随机分组率比第1组高6.4%(分别为65.3%和58.9%),但这种差异无统计学意义。与参与试验相关的因素是男性、年龄在70至75岁之间以及独居(所有p < 0.05)。
虽然避免冗长复杂的PICF文件可能有助于初步参与试验,但还需要辅以其他策略来维持对随机分组及后续试验的兴趣。在整个筛查阶段都有参与者拒绝参与试验,这表明PICF只是影响个人参与该临床试验决策的几个因素之一。