Why is recruitment to trials difficult? An investigation into recruitment difficulties in an RCT of supported employment in patients with severe mental illness
2009

Challenges in Recruiting Patients for Mental Health Trials

Sample size: 219 publication Evidence: moderate

Author Information

Author(s): Howard Louise, de Salis Isabel, Tomlin Zelda, Thornicroft Graham, Donovan Jenny

Primary Institution: King's College London

Hypothesis

What are the reasons for under-recruitment in an RCT of patients with severe mental illness?

Conclusion

Recruitment difficulties in trials involving patients with severe mental illness stem from general trial issues and specific misconceptions related to this patient group.

Supporting Evidence

  • Care coordinators had misconceptions about randomised controlled trials.
  • Clinicians expressed a lack of equipoise regarding the trial arms.
  • Patients often confused the trial with routine care, leading to therapeutic misconception.
  • Eligibility criteria were interpreted differently by various care coordinators.
  • Clinicians exhibited paternalism, prioritizing their perceptions of patient needs over informed consent.

Takeaway

It's hard to get people with severe mental illness to join research studies because they and their doctors often misunderstand how the studies work.

Methodology

Qualitative study involving interviews with trial staff and clinicians to identify recruitment barriers.

Potential Biases

Potential recall bias and the influence of clinicians' personal beliefs on patient eligibility.

Limitations

The study is based on a small sample of interviewees and may not represent all recruitment challenges.

Participant Demographics

Patients with severe mental illness, aged 18-65, with psychotic or chronic affective disorders for over 2 years.

Digital Object Identifier (DOI)

10.1016/j.cct.2008.07.007

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