Heward Michelle, Johnson Layla, Nyman Samuel R
Ageing and Dementia Research Centre, Bournemouth University, UK.
Department of Rehabilitation and Sport Science, Bournemouth University, UK.
J Frailty Sarcopenia Falls. 2022 Mar 1;7(1):1-12. doi: 10.22540/JFSF-07-001. eCollection 2022 Mar.
Randomised control trials (trials) involving people with dementia lack detailed analysis of recruitment and retention strategies. To address this, we examined the effectiveness of strategies in "The TACIT Trial: TAi ChI for people with demenTia".
We recruited dyads (people with dementia and carers) from 3 South of England sites utilising different strategies. Recruitment strategy effectiveness was measured by percent yield (number randomised of total referrals) and cost per randomised participant. Our retention strategy (maintaining contact with participants during weekly telephone calls) was measured by percent yield (number retained by six-month follow-up).
Of 359 dyads, 24% were randomised into the study (n=85). The most resource-intensive strategy (research nurses spending 30 minutes explaining the study) had the highest referral to randomisation rate. An incremental cost-effectiveness ratio suggested an alternative approach (nurses and doctors spending 5 minutes explaining the study) was most cost-effective. Retention rates were 86% (n=36/42; intervention group) and 81% (35/43; control group); main reasons for attrition were worsening health and lack of study interest.
The results demonstrate person-centred strategies enabling staff to spend time with participants were effective in supporting recruitment and retention. Those designing future trials must consider such strategies and the associated costs.
涉及痴呆症患者的随机对照试验缺乏对招募和保留策略的详细分析。为解决这一问题,我们在“默契试验:太极拳治疗痴呆症患者”中研究了相关策略的有效性。
我们从英格兰南部的3个地点招募了配对对象(痴呆症患者及其照料者),采用了不同的策略。招募策略的有效性通过产出率(随机分组的人数占总推荐人数的百分比)和每个随机分组参与者的成本来衡量。我们的保留策略(在每周的电话中与参与者保持联系)通过产出率(六个月随访时保留的人数)来衡量。
在359对配对对象中,24%被随机分组进入研究(n = 85)。资源消耗最大的策略(研究护士花30分钟解释研究)的推荐到随机分组率最高。增量成本效益比表明,另一种方法(护士和医生花5分钟解释研究)最具成本效益。保留率分别为86%(n = 36/42;干预组)和81%(35/43;对照组);损耗的主要原因是健康状况恶化和缺乏研究兴趣。
结果表明,以患者为中心、让工作人员有时间与参与者相处的策略在支持招募和保留方面是有效的。未来试验的设计者必须考虑这些策略及其相关成本。