Department of Psychiatry, University of Oxford, Oxford, UK
Oxford Precision Psychiatry Lab, NIHR Oxford Biomedical Research Centre, Oxford, UK.
BMJ Ment Health. 2023 Oct;26(1). doi: 10.1136/bmjment-2023-300774.
Participation in clinical research is associated with better patient outcomes and higher staff retention and satisfaction rates. Nevertheless, patient recruitment to mental health studies is challenging due to a reliance on clinician or patient referrals (standard approach). To empower patients and make healthcare research more equitable, we explored a novel researcher-led approach, called 'Count Me In' (CMI).
To evaluate a 12-month implementation of CMI in a routine clinical setting.
CMI was launched in August 2021 in a mental health National Health Service (NHS) Trust in England. Patients (aged 18+) learnt about CMI at their initial clinical appointment. Unless they opted out, they became contactable for research (via research informatics searches).
After 12 months, 368 patients opted out and 22 741 became contactable through CMI, including 2716 through the standard approach and 20 025 through electronic searches (637% increase). Of those identified via electronic searches, 738 were contacted about specific studies and 270 consented to participate. Five themes were identified based on patient and staff experiences of CMI: 'level of awareness and accessibility of CMI', 'perceptions of research and perceived engagement with CMI', 'inclusive research practice', 'engagement and incentives for research participation', and 'relationships between clinical and research settings'.
CMI (vs standard) led to a larger and diverse patient cohort and was favoured by patients and staff. Yet a shift in the NHS research culture is needed to ensure that this diversity translates to actual research participation.
Through collaboration with other NHS Trusts and services, key funders (National Institute for Health and Care Research) and new national initiatives (Office for Life Sciences Mental Health Mission), CMI has the potential to address recruitment challenges through rapid patient recruitment into time-sensitive country-wide studies.
参与临床研究与更好的患者结局以及更高的员工保留率和满意度相关。然而,由于依赖于临床医生或患者的转介(标准方法),精神健康研究的患者招募具有挑战性。为了赋予患者权力并使医疗保健研究更加公平,我们探索了一种新的、由研究人员主导的方法,称为“Count Me In”(CMI)。
在常规临床环境中评估 CMI 实施 12 个月的效果。
CMI 于 2021 年 8 月在英格兰的一家精神卫生国民保健服务(NHS)信托中启动。患者(18 岁以上)在首次临床预约时了解 CMI。除非他们选择退出,否则他们将可以接受研究(通过研究信息学搜索)。
12 个月后,有 368 名患者选择退出,22741 名患者通过 CMI 变得可联系,其中 2716 名患者通过标准方法,20025 名患者通过电子搜索(增加 637%)。在通过电子搜索确定的患者中,有 738 人被联系参与特定研究,有 270 人同意参与。根据患者和工作人员对 CMI 的经验,确定了五个主题:“CMI 的认知度和可及性”、“对研究的看法和对 CMI 的参与感”、“包容性研究实践”、“参与和参与研究的激励措施”以及“临床和研究环境之间的关系”。
与标准方法相比,CMI 导致了更大、更多样化的患者群体,受到患者和工作人员的青睐。然而,需要改变国民保健制度的研究文化,以确保这种多样性转化为实际的研究参与。
通过与其他国民保健制度信托和服务、主要资助者(国家卫生与保健研究所)以及新的国家倡议(生命科学精神卫生任务办公室)合作,CMI 有可能通过快速招募患者参与全国范围内的时间敏感研究,解决招募挑战。