Recruiting patients into a healthcare services trial: lessons learned from a feasibility study to investigate a patient-oriented navigation intervention for age-associated diseases.

IF 3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Kathrin Gödde, Hella Fügemann, Ulrike Grittner, Raphael Kohl, Andreas Meisel, Thomas Reinhold, Nina Rieckmann, Susanne Schnitzer, P Markus Deckert, Nikolaj Frost, Christian H Nolte, Stephan J Schreiber, Ute Goerling, Christine Holmberg
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引用次数: 0

Abstract

Background: Interventions to improve care coordination, like patient navigation programs, aim to dismantle barriers faced by patients in accessing optimal care. A variety of interventions are currently being evaluated in Germany and internationally. A key challenge of these studies, as for trials in general, is finding an effective recruitment strategy to reach the intended sample size in the targeted population.

Methods: Detailed documentation of the recruitment process was conducted as part of the process evaluation for a mixed-methods feasibility study including randomized trials and parallel cohort studies to evaluate a patient-oriented navigation program. Patients with lung cancer and stroke were actively recruited in inpatient and specialized outpatient settings in a rural and a metropolitan area in Germany between June 2021 and September 2022. Reasons for excluding or not approaching patients were documented and patients' reasons for refusal were assessed. All quantitative data were analysed in a descriptive manner. Experiences during the recruitment process were investigated through interviews with recruiting personnel and analysed through thematic analysis.

Results: The data from the screening and recruitment process show that 74-76.5% of stroke patients and 91-93% of lung cancer patients were eligible to take part in the study. Of these, 44-46.9% of inpatients and 73% of outpatients were actively approached for recruitment. Reasons for not approaching patients were mainly due to organizational and contextual factors. Documented reasons for patients' refusal to participate in the study included feeling overwhelmed (stroke patients) and not perceiving the study as relevant (lung cancer patients).

Conclusions: The presented experiences and barriers during the recruitment process for a feasibility study of a patient navigation program provide important lessons for future planning of appropriate recruitment strategies to enrol patients with age-associated diseases.

Trial registration: The study was registered at the German Clinical Trials Register (DRKS-ID: DRKS00025476, Registration Date: 04/06/2021).

招募患者参加医疗服务试验:从可行性研究中获得的经验教训,以调查针对年龄相关疾病的以患者为导向的导航干预措施。
背景:改善护理协调的干预措施,如患者导航程序,旨在消除患者在获得最佳护理时面临的障碍。目前,德国和国际上正在对各种干预措施进行评估。与一般试验一样,这些研究的一个关键挑战是找到一种有效的招募策略,以在目标人群中达到预期的样本量。方法:详细记录招募过程,作为混合方法可行性研究的过程评估的一部分,包括随机试验和平行队列研究,以评估以患者为导向的导航计划。在2021年6月至2022年9月期间,在德国农村和大都市地区的住院和专科门诊环境中积极招募肺癌和中风患者。排除或不接近患者的原因被记录下来,患者拒绝的原因被评估。所有定量数据以描述性方式进行分析。通过对招聘人员的访谈调查招聘过程中的经验,并通过专题分析进行分析。结果:从筛选和招募过程中获得的数据显示,74-76.5%的脑卒中患者和91-93%的肺癌患者符合参加研究的条件。其中,44-46.9%的住院患者和73%的门诊患者积极接触招募。不接近患者的原因主要是组织和环境因素。记录在案的患者拒绝参与研究的原因包括感到不知所措(中风患者)和不认为研究是相关的(肺癌患者)。结论:在患者导航方案可行性研究的招募过程中,所提出的经验和障碍为未来制定合适的招募策略以招募年龄相关疾病患者提供了重要的经验教训。试验注册:该研究已在德国临床试验注册中心注册(DRKS-ID: DRKS00025476,注册日期:04/06/2021)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Health Services Research
BMC Health Services Research 医学-卫生保健
CiteScore
4.40
自引率
7.10%
发文量
1372
审稿时长
6 months
期刊介绍: BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.
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