Challenges of maintaining research protocol fidelity in a clinical care setting: A qualitative study of the experiences and views of patients and staff participating in a randomized controlled trial
2011

Understanding Challenges in Diabetes Trial Protocols

Sample size: 66 publication Evidence: moderate

Author Information

Author(s): Julia Lawton, Nicholas Jenkins, Julie L. Darbyshire, Rury R. Holman, Andrew J. Farmer, Nina Hallowell

Primary Institution: University of Edinburgh

Hypothesis

Why is there limited attainment of glycaemic targets among patients in the 4-T trial?

Conclusion

The study highlights the need to consider staff experiences and the context of trial delivery to understand the limited attainment of glycaemic targets.

Supporting Evidence

  • Patients were committed to taking insulin but sometimes altered doses to avoid hypoglycaemia.
  • Staff expressed concerns about the trial's glycaemic target being too strict for some patients.
  • Patients often did not know the trial's glycaemic target and based their success on staff feedback.

Takeaway

This study looked at why people in a diabetes trial didn't always meet their blood sugar goals. It found that both patients and staff had to work together, and sometimes staff changed the rules to help patients feel safe.

Methodology

In-depth interviews with 45 patients and 21 health professionals.

Potential Biases

Potential bias from staff adapting trial protocols based on their clinical experience.

Limitations

The sample may be biased towards patients with more positive experiences due to the opt-in procedure.

Participant Demographics

Patients were broadly representative of the main trial population in terms of treatment allocation, demographics, and glycaemic control.

Statistical Information

P-Value

0.28

Statistical Significance

p=0.28

Digital Object Identifier (DOI)

10.1186/1745-6215-12-108

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