Views of healthcare professionals on recruiting to a psychosocial randomised controlled trial: a qualitative study

Trefor Aspden,Marc Serfaty,Megan Armstrong

doi:10.1186/s12913-021-06817-2

Trefor Aspden, Marc Serfaty + Show 1 more

Open Access

https://doi.org/10.1186/s12913-021-06817-2

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Abstract

BackgroundRandomised controlled trials, and in particular those of psychosocial interventions, often fail to recruit to target, resulting in underpowered trials with poor generalisability of findings. The objectives of this study were to explore the views of healthcare professionals on recruiting to psychosocial research studies, and to explore their views on factors that may hinder or facilitate recruitment.MethodsWe conducted 14 semi-structured interviews, with healthcare professionals who had been involved in recruitment into a randomised controlled trial of a talking therapy for depression in patients with advanced cancer. Interviews were transcribed and analysed using thematic analysis.ResultsFive primary themes were identified, comprised of 11 subthemes. Attitudes towards research were largely positive. Health care professionals identified lack of time and narrow screening criteria as barriers to recruitment, and also noted the tendency to withhold participants from research for reasons other than eligibility (e.g., gatekeeping). The engagement of the study team with the clinical recruitment site, and the frequent presence of a researcher in clinics, were noted as facilitating recruitment.ConclusionsHealthcare professionals involved in recruiting to trials of psychosocial interventions hold generally positive views of psychosocial research. However, they report that constraints including space and time limit their ability to recruit, and express anxieties about approaching patients for trial recruitment in the palliative phase of their illness. The findings from this study can inform how best to design trials, and in particular trials of psychosocial interventions, and train health care professionals for the study, to maximise recruitment.

Highlights

Randomised controlled trials, and in particular those of psychosocial interventions, often fail to recruit to target, resulting in underpowered trials with poor generalisability of findings
We present qualitative findings from our experience of recruitment to the CanTalk study, a Randomised controlled trial (RCT) comparing cognitive behavioural therapy (CBT) to usual care for treating depression in people with advanced cancer [12]
Our findings suggest that whilst health care professionals felt that research was important, they did not have the time to engage in recruitment, and that trials of medicinal products were often prioritised over trials of psychosocial interventions

Summary

Introduction

Randomised controlled trials, and in particular those of psychosocial interventions, often fail to recruit to target, resulting in underpowered trials with poor generalisability of findings. A survey of healthcare professionals views towards referring patients to palliative care trials suggests this desire to protect end of life patients is widespread [8]. This may be discordant with the wishes of palliative patients. A review of studies looking at the views of patients or carers towards participating in palliative care trials or research studies suggests palliative care patients are generally happy to be invited to participate in research, experience direct and indirect benefits (such as feelings of altruism) from participation, and are averse to others saying “no” on their behalf [9]. Patients with advanced cancer who had participated in symptom control trials generally regarded participating in the trial as a positive experience, irrespective of whether the trial had improved symptoms [10]

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