Bisla Jatinder, Ambler Gareth, Frank Bernhard, Gulati Sumit, Hocken Poppy, James Mairi, Kelly Joanna, Keshet-Price Jocelyn, McCabe Candy, McGylnn Deborah, Padfield Nick, Pang David, Pout Gill, Sanders Mark, Serpell Mick, Shenker Nicholas, Shoukrey Karim, Wesley Samuel, Weston Margaret, White-Alao Beverly, Wyatt Lynne, Murphy Caroline, Goebel Andreas
King's Clinical Trials Unit, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Department of Statistical Science, University College London, London, UK.
Br J Pain. 2020 Aug;14(3):171-179. doi: 10.1177/2049463719893399. Epub 2019 Dec 24.
Recruitment into trials in rare chronic pain conditions can be challenging, so such trials consequently are underpowered or fail.
Drawing from our experience in conducting, to date, the largest academic trial in a rare chronic pain condition, complex regional pain syndrome, we have identified recruitment and retention strategies for successful trial conduct.
We present 13 strategies grouped across the categories of 'setting the recruitment rate', 'networking', 'patient information', 'trial management' and 'patient retention'. Moreover, six recruitment risks are also discussed. A conservative recruitment estimate, based on audits of newly referred patients to the trial centres without taking into account availability of 'old' patients or recruitment from outside centres, and assuming a 55% patient refusal rate yielded accurate numbers.
Appreciation of these identified recruitment challenges and opportunities may contribute to supporting prospective investigators when they design clinical trials for chronic pain patient population groups where it has been historically difficult to conduct high-quality and robust clinical trials.
在罕见慢性疼痛病症中开展试验可能具有挑战性,因此此类试验往往效力不足或失败。
基于我们目前在一种罕见慢性疼痛病症——复杂性区域疼痛综合征中开展的最大规模学术试验的经验,我们确定了成功开展试验的招募和留用策略。
我们提出了13项策略,分为“设定招募率”“建立联系”“患者信息”“试验管理”和“患者留用”几类。此外,还讨论了6项招募风险。基于对新转诊至试验中心患者的审计得出的保守招募估计数是准确的,该估计未考虑“老”患者的可用性或来自外部中心的招募情况,并假设患者拒绝率为55%。
认识到这些已确定的招募挑战和机遇,可能有助于在设计针对慢性疼痛患者群体的临床试验时为潜在研究者提供支持,而在这类患者群体中开展高质量和有力的临床试验历来都很困难。