Abstract

BackgroundThere has been little research to investigate whether the appearance of paper patient information leaflets (PILs) used to describe research studies to potential participants influences their decision to take part. Embedding a study within a trial (SWAT) is an efficient way of answering this type of methodological question. We included a randomised SWAT within a large cohort study, Outcome Monitoring after Cardiac Surgery (OMACS), to address this question.MethodsPotential participants for the OMACS study were randomised to receive one of three PILs, which were identical in content but with varying formatting and use of colour: PIL A (enhanced format), PIL B (hybrid format) and PIL C (standard format). Consent to OMACS was the primary outcome. Consent rates using the three different PIL formats were collected and compared. Qualitative feedback on the different formats was obtained from a public and patient involvement (PPI) group.ResultsFor the SWAT, 1517 PILs were sent to potential participants, of whom 640 (42%) consented to take part in OMACS. PIL B had the highest recruitment rate, with 45% of patients consenting to participation; 40% and 41% of patients consented to participation after receiving PILs A and C, respectively. Compared to PIL C, the consent rate was 4% higher with PIL B (45% versus 41%, 95% confidence interval (CI) -2% to + 10%, p = 0.16) and 1% lower with PIL A (40% versus 41%, 95% CI − 7% to + 5%, p = 0.72).ConclusionsConsent rates were similar for all three PIL formats. PIL B is being used for the remainder of the host study and will be used to inform the design of PILs for other research studies, as it was the preferred format of the PPI group.Trial registrationInternational Clinical Trials Registry, ISRCTN90204321. Registered on 21 January 2015.

Highlights

  • There has been little research to investigate whether the appearance of paper patient information leaflets (PILs) used to describe research studies to potential participants influences their decision to take part

  • Much research has been conducted on how to improve patient information leaflets (PILs), the consent process, recruitment in randomised controlled trials (RCTs) and response rates to postal questionnaires, which is summarised in several reviews [1,2,3,4,5,6]

  • PIL B had the highest recruitment rate, with 45% of patients consenting to participation whereas PIL A had the lowest recruitment rate, with 40% of patients consenting to participation

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Summary

Introduction

There has been little research to investigate whether the appearance of paper patient information leaflets (PILs) used to describe research studies to potential participants influences their decision to take part. Much research has been conducted on how to improve patient information leaflets (PILs), the consent process, recruitment in randomised controlled trials (RCTs) and response rates to postal questionnaires, which is summarised in several reviews [1,2,3,4,5,6]. The main focus of that research with respect to PILs has been on the readability or length of PILs [7,8,9,10,11,12,13,14,15] and use of different media such as audio-visual materials [5] or interactive electronic materials [16], rather than how the appearance of paper PILs can be improved. This conclusion is consistent with that of previous reviews that reported that more research is required [1, 2]

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