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一项针对高血压老年患者的身体锻炼临床试验的招募方法和收益率-HAEL 研究:一项嵌套试验研究。

Recruitment methods and yield rates in a clinical trial of physical exercise for older adults with hypertension-HAEL Study: a study within a trial.

机构信息

National Institute of Science and Technology for Health Technology Assessment (IATS), Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.

Exercise Pathophysiology Research Laboratory, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.

出版信息

BMC Med Res Methodol. 2022 Feb 10;22(1):42. doi: 10.1186/s12874-022-01535-7.

Abstract

BACKGROUND

Although the prevalence of hypertension is high in older adults, clinical trial recruitment is a challenge. Our main aim was to describe the HAEL Study recruitment methods and yield rates. The secondary objectives were to explore the reasons for exclusion and to describe the characteristics of the enrolled participants.

METHODS

This is a descriptive study within a trial. The HAEL Study was a Brazilian randomized two-center, parallel trial with an estimated sample of 184 participants. The recruitment strategy was based on four methods: electronic health records, word of mouth, print and electronic flyer, and press media. The yield rate was the ratio of the number of participants who underwent randomization to the total number of volunteers screened, calculated for overall, per recruitment method, by study center and by age group and sex. Additionally, we described the reasons for exclusion in the screening phase, as well as the demographic characteristics of those enrolled. The data are presented in absolute/relative frequencies and mean ± standard deviation.

RESULTS

A total of 717 individuals were screened, and 168 were randomized over 32 months. The yield rate was higher for word of mouth (30.1%) in the overall sample. However, press media contributed the most (39.9%) to the absolute number of participants randomized in the trial. The coordinating center and participating center differed in methods with the highest yield ratios and absolute numbers of randomized participants. The main reason for exclusion in the screening phase was due to the physically active status in those intending to participate in the study (61.5%). Out of 220 participants included, 52 were excluded mainly because they did not meet the eligibility criteria (26.9%). Most of the screened volunteers were women (60.2%) age 60-69 years (59.5%), and most of the randomized participants were Caucasian/white (78.0%).

CONCLUSIONS

Multiple recruitment methods constituted effective strategies. We observed that approximately one of every four individuals screened was allocated to an intervention group. Even so, there were limitations in obtaining a representative sample of older Brazilian adults with hypertension. Data show an underrepresentation of race and age groups.

TRIAL REGISTRATION

This SWAT was not registered.

摘要

背景

尽管老年人高血压的患病率较高,但临床试验的招募仍然具有挑战性。我们的主要目的是描述 HAEL 研究的招募方法和入组率。次要目标是探讨排除的原因,并描述入组参与者的特征。

方法

这是一项试验内的描述性研究。HAEL 研究是一项巴西的随机双中心平行试验,预计样本量为 184 名参与者。招募策略基于四种方法:电子健康记录、口口相传、印刷和电子传单以及媒体宣传。入组率为随机分组的参与者数量与接受筛选的志愿者总数之比,总体、每种招募方法、每个研究中心以及按年龄组和性别计算。此外,我们还描述了筛选阶段的排除原因,以及入组者的人口统计学特征。数据以绝对/相对频率和平均值±标准差表示。

结果

共筛选了 717 人,32 个月内随机分组了 168 人。总体而言,口口相传的入组率更高(30.1%)。然而,媒体宣传对试验中随机分组的参与者绝对数量的贡献最大(39.9%)。协调中心和参与中心的招募方法存在差异,入组率和随机分组的参与者绝对数量最高。筛选阶段排除的主要原因是打算参与研究的参与者的身体活动状态(61.5%)。在纳入的 220 名参与者中,有 52 名主要因为不符合入选标准而被排除(26.9%)。筛选出的志愿者中大多数为女性(60.2%),年龄在 60-69 岁(59.5%),随机分组的参与者中大多数为白种人/高加索人(78.0%)。

结论

多种招募方法构成了有效的策略。我们发现,大约每四名接受筛选的人中就有一名被分配到干预组。尽管如此,仍难以获得具有代表性的巴西老年高血压患者样本。数据显示,在种族和年龄组方面存在代表性不足的情况。

试验注册

本研究未进行注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c24e/8832683/948c2f711cd9/12874_2022_1535_Fig1_HTML.jpg

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