Lessons From the Field

Using the ‘Social Marketing Mix Framework’ to explore recruitment barriers and facilitators in palliative care randomised controlled trials? A narrative synthesis review

“…The challenge of participant identification and complex inclusion criteria were raised as issues. 30,43,46,52,57,67,70,72 This can relate to the difficulty of predicting prognosis as part of the trial's eligibility assessment, 36,43,45,46,56,59 how palliative care is defined in a particular country 70 , too narrow and/or ambiguous inclusion criteria 43,57 and lack of suitable caregiver 72 or surrogate to gain proxy consent. 30,67 Facilitator: Broad study eligibility criteria Including broad study eligibility criteria in your protocol was seen as an aid to recruitment as it ensured a high percentage of patients screened met the study's inclusion criteria.…”

“…The right time to approach was seen as an issue in one study, 33 with patients citing the time around their initial diagnosis being the wrong time whilst others offered the intervention at the end of treatment would have preferred the intervention earlier. Gatekeeping by caregivers was also identified as an issue 46, 58, with reports of carers feeling protective towards their loved ones 46,58,72 so blocking researcher access to the patient. These findings correspond with a recent review focusing on gatekeeping in palliative care research generally.…”

“…to hospice services was also seen as a barrier to recruitment as patients were often too ill to take part in the study. 69,72 Hospice catchment areas could also be too small to provide the necessary pool of potentially eligible patients. 72 Attempting to recruit participants during hospitalisation was seen to be challenging as building rapport and trust with participants during such a stressful time can be difficult.…”

Examining the Relationship Between Modifiable Risk Factors and Levels of Functioning Among Appalachian Patients With Heart Failure

“…Recruitment rates of heart failure patients in research range between 27% and 48% (Bdeir et al, 2015;Pressler et al, 2008;Tsang, Alter, Wijeysundera, Zhang, & Ko, 2012;Zambroski, Buck, Garrison, & McMillan, 2014). Bdeir et al (2015) evaluated the impact of a nurse-led heart failure program on all cause mortality through a retrospective review of 413 patients admitted to the hospital with heart failure exacerbations.…”

“…A systematic review of women's enrollment in 328 randomized clinical trials revealed a 27% successful recruitment rate among women agreeing to participate (Tsang et al, 2012). Zambroski et al (2014) approached 99 eligible patients for a study of hospice heart failure patients and 32 agreed to participate (32.3%).…”