A methodological study investigating factors influencing the recruitment and attrition of participants in palliative care research.

Abstract

Background: Clinical palliative care research is challenging because of low recruitment and high attrition rates, although clinical research is much needed to improve the care provided.

Aims: To identify key barriers for recruitment and main reasons for attrition in palliative care research.

Methods: This methodological study was based on Danish participation in an international questionnaire study. All patients referred to the specialist palliative care teams at two hospitals between August 2022 and November 2023 were screened for eligibility. Data were analysed using descriptive statistics.

Findings: Of the 681 patients screened, 236 (34.7%) were eligible for inclusion, and 59 (25.0% of eligible patients) completed the study. The most commonly reported reason for non-inclusion was physical frailty (15.3%). Eligible and ineligible patients differed significantly with respect to diagnosis and median survival, which was 75 days among eligible patients compared with 45 days among ineligible patients. No attrition occurred after enrolment, likely reflecting a restrictive inclusion practice.

Conclusions: Systematic screening and direct clinical assessment may support more effective recruitment and help reduce gatekeeping in palliative care research.

Implications for practice: Researchers and clinicians should adopt systematic and transparent recruitment processes, minimise unnecessary exclusion criteria and use clinically informed assessments of eligibility to reduce gatekeeping. Using less burdensome data collection methods may improve recruitment, enhance participant retention and increase the inclusivity and quality of palliative care research.