University of New Mexico, Department of Psychiatric Research, Albuquerque, New Mexico.
Harvard Medical School, Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts.
West J Emerg Med. 2023 Feb 20;24(2):228-235. doi: 10.5811/westjem.2022.11.57179.
Clinical trial recruitment and retention of individuals who use substances are challenging in any setting and can be particularly difficult in emergency department (ED) settings. This article discusses strategies for optimizing recruitment and retention in substance use research conducted in EDs.
Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED) was a National Drug Abuse Treatment Clinical Trials Network (CTN) protocol designed to assess the impact of a brief intervention with individuals screening positive for moderate to severe problems related to use of non-alcohol, non-nicotine drugs. We implemented a multisite, randomized clinical trial at six academic EDs in the United States and leveraged a variety of methods to successfully recruit and retain study participants throughout the 12-month study course. Recruitment and retention success is attributed to appropriate site selection, leveraging technology, and gathering adequate contact information from participants at their initial study visit.
The SMART-ED recruited 1,285 adult ED patients and attained follow-up rates of 88%, 86%, and 81% at the 3-, 6-, and 12-month follow-up periods, respectively. Participant retention protocols and practices were key tools in this longitudinal study that required continuous monitoring, innovation, and adaptation to ensure strategies remained culturally sensitive and context appropriate through the duration of the study.
Tailored strategies that consider the demographic characteristics and region of recruitment and retention are necessary for ED-based longitudinal studies involving patients with substance use disorders.
在任何环境下,招募和保留使用物质的个体参与临床试验都具有挑战性,而在急诊科(ED)环境中则更为困难。本文讨论了在急诊科进行物质使用研究中优化招募和保留的策略。
急诊科中的筛查、动机评估、转介和治疗(SMART-ED)是国家药物滥用治疗临床试验网络(CTN)的一项方案,旨在评估对中度至重度与非酒精、非尼古丁药物使用相关问题呈阳性筛查的个体进行简短干预的效果。我们在美国六家学术性急诊科实施了一项多站点、随机临床试验,并利用各种方法在整个 12 个月的研究过程中成功招募和保留了研究参与者。招募和保留的成功归因于适当的选址、利用技术以及在参与者首次研究就诊时收集足够的联系信息。
SMART-ED 招募了 1285 名成年 ED 患者,分别在 3、6 和 12 个月的随访期间,获得了 88%、86%和 81%的随访率。参与者保留协议和实践是这项需要持续监测、创新和适应的纵向研究中的关键工具,以确保策略在研究期间保持文化敏感性和符合背景要求。
针对参与物质使用障碍患者的 ED 为基础的纵向研究,需要考虑招募和保留的人口统计学特征和地区的定制策略。