Abstract
BackgroundThis article describes the challenges a research team experienced recruiting physicians within a randomised controlled trial about leg ulcer care that seeks to foster the cooperation between the medical and nursing professions. Community-based physicians in North Rhine-Westphalia, Germany, were recruited for an interdisciplinary intervention designed to enhance leg ulcer patients' self-care agency. The aim of this article is to investigate the success of different recruitment strategies employed and reasons for physicians' non-participation.MethodsThe first recruitment phase stressed the recruitment of GPs, the second the recruitment of specialists. Throughout the recruitment process data were collected through phone conversations with GP practices who indicated reasons for non-participation.ResultsDespite great efforts to recruit physicians, the recruitment rate reached only 26 out of 1549 contacted practices (1.7%) and 12 out of 273 (4.4%) practices during the first and second recruitment phase respectively. The overall recruitment rate over the 16-month recruitment period was 2%. With a target recruitment rate of n = 300, only 45 patients were enrolled in the study, not meeting study projections. Various reasons for community physicians' non-participation are presented as stated spontaneously during phone conversations that might explain low recruitment rates. The recruitment strategy utilised is discussed against the background of factors associated with high participation rates from the international literature.ConclusionTime, money, and effort needed during the planning and recruitment phase of a study must not be underestimated to avoid higher than usual rates of refusal and lack of initial contact. Pilot studies prior to a study start-up may provide some evidence on whether the target recruitment rate is feasible.Trial registrationCurrent Controlled Trials ISRCTN42122226.
Highlights
This article describes the challenges a research team experienced recruiting physicians within a randomised controlled trial about leg ulcer care that seeks to foster the cooperation between the medical and nursing professions
With a target recruitment rate of n = 300, only 45 patients were enrolled in the study, not meeting study projections
The recruitment strategy utilised is discussed against the background of factors associated with high participation rates from the international literature
Summary
This article describes the challenges a research team experienced recruiting physicians within a randomised controlled trial about leg ulcer care that seeks to foster the cooperation between the medical and nursing professions. Community-based physicians in North Rhine-Westphalia, Germany, were recruited for an interdisciplinary intervention designed to enhance leg ulcer patients' self-care agency. The German health care system has no gatekeeping functions; instead patients are free to select a doctor of their choice (GP or specialist) who is located in the community. Since there is no mechanism to control this "self-selected" gatekeeping, patients frequently choose specialists directly. For German GPs it is financially rather unattractive to treat leg ulcer patients as the entire treatment has to be financed from the physicians overall budget, which ranges between 32 and 45 Euro per quarter and patient, depending on the federal state. The more often leg ulcer patients' visit their GP and the more material (e.g. wound dressing) they need, the greater the risk of budgetary overspending
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have