Recruitment difficulties in a primary care cluster randomised trial: investigating factors contributing to general practitioners' recruitment of patients

Page, Matthew J.; French, Simon D.; McKenzie, Joanne E.; O'Connor, Denise A.; Green, Sally E.
January 2011
BMC Medical Research Methodology;2011, Vol. 11 Issue 1, p35
Academic Journal
Background: Recruitment of patients by health professionals is reported as one of the most challenging steps when undertaking studies in primary care settings. Numerous investigations of the barriers to patient recruitment in trials which recruit patients to receive an intervention have been published. However, we are not aware of any studies that have reported on the recruitment barriers as perceived by health professionals to recruiting patients into cluster randomised trials where patients do not directly receive an intervention. This particular subtype of cluster trial is commonly termed a professional-cluster trial. The aim of this study was to investigate factors that contributed to general practitioners recruitment of patients in a professional-cluster trial which evaluated the effectiveness of an intervention to increase general practitioners adherence to a clinical practice guideline for acute low-back pain. Method: General practitioners enrolled in the study were posted a questionnaire, consisting of quantitative items and an open-ended question, to assess possible reasons for poor patient recruitment. Descriptive statistics were used to summarise quantitative items and responses to the open-ended question were coded into categories. Results: Seventy-nine general practitioners completed at least one item (79/94 = 84%), representing 68 practices (85% practice response rate), and 44 provided a response to the open-ended question. General practitioners recalled inviting a median of two patients with acute low-back pain to participate in the trial over a seven-month period; they reported that they intended to recruit patients, but forgot to approach patients to participate; and they did not perceive that patients had a strong interest or disinterest in participating. Additional open-ended comments were generally consistent with the quantitative data. Conclusion: A number of barriers to the recruitment of patients with acute low-back pain by general practitioners in a professional-cluster trial were identified. These barriers were similar to those that have been identified in the literature surrounding the recruitment of patients in individual patient randomised trials. To advance the evidence base for patient recruitment strategies in primary care settings, trialists undertaking professional-cluster trials need to develop and evaluate patient recruitment strategies that minimise the efforts required by practice staff to recruit patients, while also meeting privacy and ethical responsibilities and minimising the risk of selection bias. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN012606000098538 (date registered 14/03/ 2006).


Related Articles

  • A clinical trial alert tool to recruit large patient samples and assess selection bias in general practice research. Heinemann, Stephanie; Thüring, Sabine; Wedeken, Sven; Schäfer, Tobias; Scheidt-Nave, Christa; Ketterer, Mirko; Himmel, Wolfgang // BMC Medical Research Methodology;2011, Vol. 11 Issue 1, p16 

    Background: Many research projects in general practice face problems when recruiting patients, often resulting in low recruitment rates and an unknown selection bias, thus limiting their value for health services research. The objective of the study is to evaluate the recruitment performance of...

  • The reality of undertaking research in podiatry: challenges and experiences of two clinical podiatry researchers. Etoria-King, Hazel; Amor, Tim; Deehan, Ann // Podiatry Now;May2009, Vol. 12 Issue 5, p30 

    The article offers a look at the practical experiences of two clinical podiatrists in undertaking a randomized controlled trial (RCT) within a hospital environment while on secondment from their primary care trust (PCT) clinical commitments. The challenges posed by recruiting trial participants...

  • What does it cost to establish a practice-nurses-led clinical trial in general practice? Blackberry, Irene D.; Furler, John S.; Young, Doris; Best, James D. // Medical Journal of Australia;11/2/2009, Vol. 191 Issue 9, p492 

    The article discusses the results of a study to determine the costs of engaging the services of practice nurses (PNs) involved in randomised controlled clinical trials of diabetes in Australia. The role of PNs in primary care research is expected to increase but the costs of employing PNs in...

  • Clinical leadership for general practice nurses, part 1: Perceived needs. Burns, Dianne // Practice Nursing;Sep2009, Vol. 20 Issue 9, p466 

    As UK primary care undergoes rapid change, general practice nurses face great challenges in providing quality care in a cost-contained environment. These challenges require the application of clinical leadership. Aim: To describe the concept of clinical leadership from a general practice nurse's...

  • Measuring success. Wilson, C. Ruth // Canadian Family Physician;Mar2008, Vol. 54 Issue 3, p477 

    The author reflects on the effectiveness of Canadian family medicine. She argues that electronic medical records, and performance measures in Canada was behind other countries. Also, she stated that the Canadian coordinating body for primary health research needs improvement. The author inferred...

  • Medical Research Network.  // Applied Clinical Trials;Dec2011, Vol. 20 Issue 12, p91 

    The article presents a corporate profile of the Medical Research Network Ltd. (MRN), which is focused on patient recruitment and patient retention for clinical trials.

  • Summary of: The views of dentists on their participation in a primary care-based research trial. Hopper, L.; Aspinall, A.; Mackie, I. C.; Blinkhorn, F. A. // British Dental Journal;7/26/2008, Vol. 205 Issue 2, p86 

    Aims To determine the attitudes and opinions of dentists undertaking research in primary care dental practices, about the value of research in primary care.Method The data were collected during a face-to-face interview utilising a schedule of open and closed questions, which were used to guide...

  • Evidence for risk of bias in cluster randomised trials: review of recent trials published in three general medical journals. Puffer, Suezann; Torgerson, David J.; Watson, Judith // BMJ: British Medical Journal (International Edition);10/4/2003, Vol. 327 Issue 7418, p785 

    Objective: To examine the prevalence of a risk of bias associated with the design and conduct of cluster randomised controlled trials among a sample of recently published studies. Design Retrospective review of cluster randomised trials published in the BMJ, Lancet, and New England Journal of...

  • Factors Influencing Physician Participation in Practice-Based Research Network Studies. Croughan, Mary // Journal of Family Practice;Nov2001, Vol. 50 Issue 11, p978 

    The author comments on two studies published within the issue about the factors influencing physician participation in practice-based research network studies. They include a study about participation and successful recruitment in primary care and another study on the rate of case reporting,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics