Recruiting and retaining participants in three randomised controlled trials of psychological interventions conducted on acute psychiatric wards: top ten tips for success

Abstract

Background It is essential to conduct randomised controlled trials of psychological interventions on acute psychiatric wards to build a robust evidence base for clinical practice. Aims This paper aims to share strategies from three different in-patient trials that successfully recruited and retained participants, to disseminate good practice for the conduct of future trials in this challenging and complex clinical setting. Method We present strategies from three in-patient trials of psychological interventions: TULIPS (Talk, Understand, Listen for Inpatient Settings), amBITION (Brief Talking Therapies on Wards) and INSITE (Inpatient Suicide Intervention and Therapy Evaluation). All studies recruited participants from acute in-patient wards, initiated therapy within the in-patient setting and followed up on participants post-discharge. Results We summarise our recommendations for good practice in the form of ten top tips for success, based on our collective experience of conducting trials on psychiatric wards. Key themes relate to the importance of relationships between the research team and clinical staff; good stakeholder involvement and getting early buy-in from the team; and adapting to the particular demands of the clinical setting. Conclusions Sharing good practice recommendations can help reduce research waste arising from poor recruitment and/or retention in future in-patient clinical trials.

Autopsy of a failed trial part 1: A qualitative investigation of clinician's views on and experiences of the implementation of the DAISIES trial in UK‐based intensive eating disorder services

“…This tension was commonly expressed around decision‐making for stepping‐down patients from IP to DP services. Previous authors have suggested that trial research processes should be well‐integrated into the existing working patterns of clinicians (Team et al., 2018 ), especially within IP services (Jacobsen et al., 2022 ), since clinical responsibilities will always take priority over those of research (Elliott et al., 2017 ). These previously‐disseminated challenges were however known to the DAISIES team, being comprised of a group of experienced trialists, and several mitigating strategies were implemented (İnce et al, 2023 ) including assigning research champion roles to clinicians, shown previously to improve recruitment within mental health service contexts (Oduola et al., 2017 ).…”

“…There were several facilitators in the value proposition domain, including staff belief in the importance of the trial, and a perception that altruism would motivate participation, consistent with literature on patient‐centred enablers of recruitment (Houghton et al., 2020 ). Previous research has identified positive opinions of a trial amongst recruiting staff, good communication, and supportive relationships between research and clinical teams as facilitators of trial success (Borschmann et al., 2014 ; Jacobsen et al., 2022 ; Peckham et al., 2018 ; Team et al., 2018). All were present in the DAISIES trial; however, the utility of these facilitators as well as the mitigation strategies applied by the DAISIES team appear to have been overshadowed by other implementation barriers.…”