1
|
Hung M, Mohajeri A, Almpani K, Carberry G, Wisniewski JF, Janes K, Janes B, Hardy C, Zakeri G, Raymond B, Trinh H, Bretner J, Cheever VJ, Garibyan R, Bachstein P, Licari FW. Successes and Challenges in Clinical Trial Recruitment: The Experience of a New Study Team. Med Sci (Basel) 2024; 12:39. [PMID: 39189202 PMCID: PMC11348161 DOI: 10.3390/medsci12030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/05/2024] [Accepted: 08/12/2024] [Indexed: 08/28/2024] Open
Abstract
Participant recruitment is one of the most challenging aspects of a clinical trial, directly impacting both the study's duration and the quality of its results. Therefore, reporting successful recruitment strategies is crucial. This study aimed to document the recruitment tactics and experiences of a research team during a university-based randomized clinical trial, conducted as part of a clinical research immersion program. Recruitment took place from October 2021 to October 2022. Before the study commenced, study team members received formal training in clinical trial participant recruitment from the Principal Investigator. The recruitment strategies were integrated into initial study design, which was approved by the Institutional Review Board. A multimodal approach was employed, incorporating both direct and indirect recruitment methods. These strategies successfully met the enrollment target within the twelve-month period. Throughout the process, team members acquired valuable knowledge in recruitment design and implementation, along with transferable interpersonal and networking skills. In-person recruitment was the most efficient and cost-effective strategy, followed by personal referrals. The primary challenge was accommodating participants' availability. Other study teams should consider these recruitment strategies during their study designs. Additionally, the knowledge and skills gained by this study team underscore the value of experiential learning in research education.
Collapse
Affiliation(s)
- Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
- Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA
- College of Engineering, University of Utah, Salt Lake City, UT 84108, USA
- Department of Educational Psychology, University of Utah, Salt Lake City, UT 84108, USA
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
- Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Amir Mohajeri
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Konstantinia Almpani
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Gabriel Carberry
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - John F. Wisniewski
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Kade Janes
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Brooklyn Janes
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Chase Hardy
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Golnoush Zakeri
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Ben Raymond
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Heather Trinh
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Jordan Bretner
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Val J. Cheever
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Rafael Garibyan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Perry Bachstein
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Frank W. Licari
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| |
Collapse
|
2
|
Tenison E, Smith MD, Pendry-Brazier D, Cullen A, Lithander FE, Ben-Shlomo Y, Henderson EJ. Enhancing recruitment of individuals living with frailty, multimorbidity and cognitive impairment to Parkinson's research: experiences from the PRIME-UK cross-sectional study. Age Ageing 2024; 53:afae108. [PMID: 38783753 PMCID: PMC11116826 DOI: 10.1093/ageing/afae108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES People with parkinsonism who are older, living in a care home, with frailty, multimorbidity or impaired capacity to consent are under-represented in research, limiting its generalisability. We aimed to evaluate more inclusive recruitment strategies. METHODS From one UK centre, we invited people with parkinsonism to participate in a cross-sectional study. Postal invitations were followed by telephone reminders and additional support to facilitate participation. Personal consultees provided information on the views regarding research participation of adults with impaired capacity. These approaches were evaluated: (i) using external data from the Parkinson's Real World Impact assesSMent (PRISM) study and Clinical Practice Research Datalink (CPRD), a sample of all cases in UK primary care, and (ii) comparing those recruited with or without intensive engagement. RESULTS We approached 1,032 eligible patients, of whom 542 (53%) consented and 477 (46%) returned questionnaires. The gender ratio in PRIME-UK (65% male) closely matched CPRD (61% male), unlike in the PRISM sample (46%). Mean age of PRIME participants was 75.9 (SD 8.5) years, compared to 75.3 (9.5) and 65.4 (8.9) years for CPRD and PRISM, respectively. More intensive engagement enhanced recruitment of women (13.3%; 95% CI 3.8, 22.9%; P = 0.005), care home residents (6.2%; 1.1, 11.2%; P = 0.004), patients diagnosed with atypical parkinsonism (13.7%; 5.4, 19.9%; P < 0.001), and those with a higher frailty score (mean score 0.2, 0.1, 0.2; P < 0.001). CONCLUSIONS These recruitment strategies resulted in a less biased and more representative sample, with greater inclusion of older people with more complex parkinsonism.
Collapse
Affiliation(s)
- Emma Tenison
- Ageing and Movement Research Group, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1NU, UK
- Older People’s Unit, Royal United Hospitals Bath NHS Foundation Trust, Bath BA1 3NG, UK
| | - Matthew D Smith
- Ageing and Movement Research Group, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1NU, UK
- Older People’s Unit, Royal United Hospitals Bath NHS Foundation Trust, Bath BA1 3NG, UK
| | - Danielle Pendry-Brazier
- Ageing and Movement Research Group, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1NU, UK
| | - Anisha Cullen
- Ageing and Movement Research Group, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1NU, UK
| | - Fiona E Lithander
- Ageing and Movement Research Group, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1NU, UK
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand
| | - Yoav Ben-Shlomo
- Ageing and Movement Research Group, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1NU, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Emily J Henderson
- Ageing and Movement Research Group, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1NU, UK
- Older People’s Unit, Royal United Hospitals Bath NHS Foundation Trust, Bath BA1 3NG, UK
| |
Collapse
|
3
|
Stuckenschneider T, Schmidt L, Speckmann EM, Koschate J, Zieschang T. Recruiting patients for falls prevention in the emergency department - worth the challenge. BMC Geriatr 2023; 23:880. [PMID: 38129767 PMCID: PMC10740331 DOI: 10.1186/s12877-023-04607-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/16/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Severe falls escalate the risk of future falls and functional decline as indicated by recent global guidelines. To establish effective falls prevention, individuals at highest risk must be thoroughly studied and, therefore, successfully recruited. OBJECTIVE Recruiting from an emergency department (ED) may mitigate common selection biases, such as overrepresentation of individuals with a higher social status and healthier lifestyle. However, this approach presents unique challenges due to ED-specific conditions. Hence, we present the successes and challenges of an ED-based recruitment for an observational study. METHODS The SeFallED study targets older adults aged ≥60 years, who present to either of two hospitals in Oldenburg after a fall without subsequent admission. A study nurse addressed individuals in the EDs. Subsequently, potential participants were contacted by phone to arrange a home visit for obtaining written consent. Data of participants were compared with total admissions during the recruitment period to determine recruitment rate and compare patients' characteristics. RESULTS Over 1.500 individuals met the inclusion criteria. Of these, 288 participants were successfully recruited. Most patients presented to the ED outside of the study team's working hours, and some opted not to participate (main reason: too unwell (40%)). Compared to working hours, a participant was recruited every 14 h. Comparing characteristics, a trend towards better health and younger age was observed. CONCLUSION ED-based recruitment offers the opportunity to include more diverse individuals in falls prevention. To achieve adequate sample sizes, flexibility in working days and hours of the research team are obligatory. TRIAL REGISTRATION DRKS00025949.
Collapse
Affiliation(s)
- Tim Stuckenschneider
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Ammerländer Heerstraße 114-118, Lower Saxony, 26129, Oldenburg, Germany.
| | - Laura Schmidt
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Ammerländer Heerstraße 114-118, Lower Saxony, 26129, Oldenburg, Germany
| | - Elisa-Marie Speckmann
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Ammerländer Heerstraße 114-118, Lower Saxony, 26129, Oldenburg, Germany
| | - Jessica Koschate
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Ammerländer Heerstraße 114-118, Lower Saxony, 26129, Oldenburg, Germany
| | - Tania Zieschang
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Ammerländer Heerstraße 114-118, Lower Saxony, 26129, Oldenburg, Germany
| |
Collapse
|
4
|
Sheikh S, Fernandez R, Smotherman C, Brailsford J, Langaee T, Velasquez E, Henson M, Munson T, Bertrand A, Hendry P, Anton S, Fillingim RB, Cavallari LH. A pilot study to identify pharmacogenomic and clinical risk factors associated with opioid related falls and adverse effects in older adults. Clin Transl Sci 2023; 16:2331-2344. [PMID: 37705211 PMCID: PMC10651658 DOI: 10.1111/cts.13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/01/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
Given the high prevalence of pain in older adults and current trends in opioid prescribing, inclusion of genetic information in risk prediction tools may improve opioid risk assessment. Our objectives were to (1) determine the feasibility of recruiting socioeconomically disadvantaged and racially diverse middle aged and older adult populations for a study seeking to identify risk factors for opioid-related falls and other serious adverse effects and (2) explore potential associations between the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) risk class and other patient factors with falls and serious opioid adverse effects. This was an observational study of 44 participants discharged home from the emergency department with an opioid prescription for acute pain and followed for 30 days. We found pain interference may predict opioid-related falls or serious adverse effects within older, opioid-treated patients. If validated, pain interference may prove to be a beneficial marker for risk stratification of older adults initiated on opioids for acute pain.
Collapse
Affiliation(s)
- Sophia Sheikh
- Department of Emergency MedicineUniversity of Florida College of Medicine‐JacksonvilleJacksonvilleFloridaUSA
| | - Rosemarie Fernandez
- Department of Emergency MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Carmen Smotherman
- Center for Data SolutionsUniversity of Florida, College of Medicine‐JacksonvilleJacksonvilleFloridaUSA
| | - Jennifer Brailsford
- Center for Data SolutionsUniversity of Florida, College of Medicine‐JacksonvilleJacksonvilleFloridaUSA
| | - Taimour Langaee
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics and Precision MedicineUniversity of Florida College of PharmacyGainesvilleFloridaUSA
| | - Esteban Velasquez
- Department of Emergency MedicineUniversity of Florida College of Medicine‐JacksonvilleJacksonvilleFloridaUSA
| | - Morgan Henson
- Department of Emergency MedicineUniversity of Florida College of Medicine‐JacksonvilleJacksonvilleFloridaUSA
| | - Taylor Munson
- Department of Emergency MedicineUniversity of Florida College of Medicine‐JacksonvilleJacksonvilleFloridaUSA
| | - Andrew Bertrand
- Department of Emergency MedicineUniversity of Florida College of Medicine‐JacksonvilleJacksonvilleFloridaUSA
| | - Phyllis Hendry
- Department of Emergency MedicineUniversity of Florida College of Medicine‐JacksonvilleJacksonvilleFloridaUSA
| | - Stephen Anton
- Department of Physiology and AgingUniversity of FloridaGainesvilleFloridaUSA
| | - Roger B. Fillingim
- Department of Community Dentistry and Behavioral ScienceUniversity of Florida College of DentistryGainesvilleFloridaUSA
| | - Larisa H. Cavallari
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics and Precision MedicineUniversity of Florida College of PharmacyGainesvilleFloridaUSA
| |
Collapse
|
5
|
Hatahet O, Roser F, Seghier ML. Cognitive decline assessment in speakers of understudied languages. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12432. [PMID: 37942084 PMCID: PMC10629372 DOI: 10.1002/trc2.12432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/20/2023] [Accepted: 10/03/2023] [Indexed: 11/10/2023]
Abstract
Projected trends in population aging have forecasted a massive increase in the number of people with dementia, in particular in sub-Saharan Africa and the Middle East and North Africa (MENA) region. Cognitive decline is a significant marker for dementia, typically assessed with standardized neuropsychological tools that have been validated in some well-researched languages such as English. However, with the existing language diversity, current tools cannot cater to speakers of understudied languages, putting these populations at a disadvantage when it comes to access to early and accurate diagnosis of dementia. Here, we shed light on the detrimental impact of this language gap in the context of the MENA region, highlighting inadequate tools and an unacceptable lack of expertise for a MENA population of a half billion people. Our perspective calls for more research to unravel the exact impact of the language gap on the quality of cognitive decline assessment in speakers of understudied languages. Highlights Cognitive decline is a marker for dementia, assessed with neuropsychological tests.There is a lack of culturally valid tests for speakers of understudied languages.For example, suboptimal cognitive tests are used in the Middle East and North Africa region.Linguistic diversity should be considered in the development of cognitive tests.
Collapse
Affiliation(s)
- Oula Hatahet
- Department of Biomedical EngineeringKhalifa University of Science and TechnologyAbu DhabiUnited Arab Emirates
| | - Florian Roser
- Neurological InstituteCleveland Clinic Abu Dhabi, Al Maryah IslandAbu DhabiUnited Arab Emirates
| | - Mohamed L. Seghier
- Department of Biomedical EngineeringKhalifa University of Science and TechnologyAbu DhabiUnited Arab Emirates
- Healthcare Engineering Innovation Center (HEIC)Khalifa University of Science and TechnologyAbu DhabiUnited Arab Emirates
| |
Collapse
|
6
|
Salminen M, Stenholm S, Koskenniemi J, Korhonen P, Pitkänen T, Viikari P, Wuorela M, Viitanen M, Viikari L. Senior Health Clinic for 75-year-old home-dwelling Finns - study design, clinic protocol and non-response analysis. BMC Health Serv Res 2023; 23:210. [PMID: 36864394 PMCID: PMC9981251 DOI: 10.1186/s12913-023-09199-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/19/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND In the Finnish policy on older people preventive activities, which maintain functional capacity and independent living, are emphasized. The Turku Senior Health Clinic, aimed at maintaining independent coping of all home-dwelling 75-year-old citizens in the city of Turku, was founded in the beginning of 2020. The aim of this paper is to describe design and protocol of the Turku Senior Health Clinic Study (TSHeC) and provide results of the non-response analysis. METHODS The non-response analysis used data from 1296 participants (71% of those eligible) and 164 non-participants of the study. Sociodemographic, health status, psychosocial and physical functional ability indicators were included in the analysis. Participants and non-participants were also compared in respect to their neighborhood socioeconomic disadvantage. Differences between participants and non-participants were tested using the Chi squared or Fisher´s exact test for categorical variables and t-test for continuous variable. RESULTS The proportions of women (43% vs. 61%) and of those with only satisfying, poor or very poor self-rated financial status (38% vs. 49%) were significantly lower in non-participants than in participants. Comparison of the non-participants and participants in respect to their neighborhood socioeconomic disadvantage showed no differences. The prevalence of hypertension (66% vs. 54%), chronic lung disease (20% vs. 11%), and kidney failure (6% vs. 3%) were higher among non-participants compared to participants. Feelings of loneliness were less frequent among non-participants (14%) compared to participants (32%). The proportions of those using assistive mobility devices (18% vs. 8%) as well as those having previous falls (12% vs. 5%) were higher in non-participants than in participants. CONCLUSIONS The participation rate of TSHeC was high. No neighborhood differences in participation were found. Health status and physical functioning of non-participants seemed to be slightly worse than those of the participants, and more women than men participated. These differences may weaken the generalizability of the findings of the study. The differences have to be taken into account when recommendation for the content and implementation of preventive nurse-managed health clinic in primary health care in Finland is going to be given. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.
Collapse
Affiliation(s)
- Marika Salminen
- Turku University Hospital/Medical domain, Wellbeing services county of Southwest Finland, Turku, FIN-20521 Turku, Finland. .,Faculty of Medicine, Department of General Practice, University of Turku, Joukahaisenkatu 3-5 A, Turku, 20014, Finland.
| | - Sari Stenholm
- grid.1374.10000 0001 2097 1371Department of Public Health, Faculty of Medicine, University of Turku and Turku University Hospital, 20014 Turku, Finland ,grid.1374.10000 0001 2097 1371Centre for Population Health Research, University of Turku and Turku University Hospital, 20014 Turku, Finland
| | - Jaana Koskenniemi
- grid.1374.10000 0001 2097 1371Turku University Hospital/Medical domain, Wellbeing services county of Southwest Finland, Turku, FIN-20521 Turku Finland
| | - Päivi Korhonen
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of General Practice, University of Turku, Joukahaisenkatu 3-5 A, Turku, 20014 Finland
| | - Tiina Pitkänen
- grid.1374.10000 0001 2097 1371Turku University Hospital/Medical domain, Wellbeing services county of Southwest Finland, Turku, FIN-20521 Turku Finland
| | - Paula Viikari
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700 Finland
| | - Maarit Wuorela
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700 Finland
| | - Matti Viitanen
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700 Finland ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, NVS, Karolinska Institutet, Karolinska University Hospital, Huddinge, 14186 Stockholm, Sweden
| | - Laura Viikari
- grid.1374.10000 0001 2097 1371Faculty of Medicine, Department of Geriatric Medicine, University of Turku and Turku University Hospital, Kunnallissairaalantie 20, Turku, 20700 Finland
| |
Collapse
|
7
|
Godbole N, Kwon SC, Beasley JM, Roberts T, Kranick J, Smilowitz J, Park A, Sherman SE, Trinh-Shevrin C, Chodosh J. Assessing Equitable Inclusion of Underrepresented Older Adults in Alzheimer's Disease, Related Cognitive Disorders, and Aging-Related Research: A Scoping Review. THE GERONTOLOGIST 2022:6574426. [PMID: 35472166 DOI: 10.1093/geront/gnac060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The rapidly aging and diversifying U.S. population is challenged by increases in prevalence of Alzheimer's disease (AD) and aging-related disorders. We conducted a scoping review to assess equitable inclusion of diverse older adult populations in aging research focused on National Institutes of Health (NIH)-sponsored research. RESEARCH DESIGN AND METHODS The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-Scr) Protocol. The search was limited to NIH-funded studies focusing on aging, AD and Alzheimer's disease-related dementias (ADRD) and included adults aged 55+. The priority populations and health disparities put forth by the NIA Health Disparities Framework serve as a model for guiding inclusion criteria and for interpreting the representation of these underrepresented groups, including racial ethnic minorities, socioeconomically disadvantaged, rural populations, groups with disabilities, and LGBTQ communities. RESULTS Our search identified 1,177 records, of which 436 articles were included in the analysis. Inclusion of individuals with ADRD and mild cognitive impairment, racial ethnic minorities, rural populations, socioeconomically disadvantaged, groups with disabilities, and LGBTQ communities were poorly specified in most studies. Studies used multiple recruitment methods, conducting studies in community settings (59%) and hospitals/clinics (38%) most frequently. Incentives, convenience factors, and sustained engagement via community-based and care partners were identified as key strategies for improved retention. DISCUSSION AND IMPLICATIONS This scoping review identified gaps in existing literature and aims for future work, including stronger research focus on, better inclusion of, and improved data collection and reporting of older adults from underrepresented groups.
Collapse
Affiliation(s)
- Nisha Godbole
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | | | | | | | | | | | - Agnes Park
- NYU Grossman School of Medicine, New York, NY, USA
| | - Scott E Sherman
- NYU Grossman School of Medicine, New York, NY, USA.,VA New York Harbor Healthcare System, New York, NY, USA
| | | | - Joshua Chodosh
- NYU Grossman School of Medicine, New York, NY, USA.,VA New York Harbor Healthcare System, New York, NY, USA
| |
Collapse
|
8
|
Woolf B, Edwards P. Does advance contact with research participants increase response to questionnaires: an updated systematic review and meta-analysis. BMC Med Res Methodol 2021; 21:265. [PMID: 34837965 PMCID: PMC8627623 DOI: 10.1186/s12874-021-01435-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background Questionnaires remain one of the most common forms of data collection in epidemiology, psychology and other human-sciences. However, results can be badly affected by non-response. One way to potentially reduce non-response is by sending potential study participants advance communication. The last systematic review to examine the effect of questionnaire pre-notification on response is 10 years old, and lacked a risk of bias assessment. Objectives Update the section of the Cochrane systematic review, Edwards et al. (2009), on pre-notification to include 1) recently published studies, 2) an assessment of risk of bias, 3) Explore if heterogeneity is reduced by: delay between pre-contact and questionnaire delivery, the method of pre-contact, if pre-contact and questionnaire delivery differ, if the pre-contact includes a foot-in-the-door manipulation, and study’s the risk of bias. Methods Inclusion criteria: population: any population, intervention: comparison of some type of pre-notification, comparison group: no pre-notification, outcome: response rates. Study design: randomised controlled trails. Exclusion criteria: NA. Data sources: Studies which cited or were included in Edwards et al. (2009); We additionally searched: CINAHL, Web of Science, PsycInfo, MEDLINE, EconLit, EMBASE, Cochrane Central, Cochrane CMR, ERIC, and Sociological Abstracts. The searches were implemented in June 2018 and May 2021. Study screening: a single reviewer screened studies, with a random 10% sample independently screened to ascertain accuracy. Data extraction: data was extracted by a single reviewer twice, with a week between each extraction. Risk of Bias: within studies bias was assessed using the Cochrane Risk of Bias tool (ROB1) by a single unblinded reviewer, across studies bias was assessed using funnel plots. Synthesis Method: study results were meta-analysed with a random effects model using the final response rate as the outcome. Evaluation of Uncertainty: Uncertainty was evaluated using the GRADE approach. Results One hundred seven trials were included with 211,802 participants. Over-all pre-notification increased response, OR = 1.33 (95% CI: 1.20–1.47). However, there was a large amount of heterogeneity (I2 = 97.1%), which was not explained by the subgroup analyses. In addition, when studies at high or unclear risk of bias were excluded the effect was to reduced OR = 1.09 (95% CI: 0.99–1.20). Because of the large amount of heterogeneity, even after restricting to low risk of bias studies, there is still moderate uncertainty in these results. Conclusions Using the GRADE evaluation, this review finds moderate evidence that pre-notification may not have an effect on response rates. Funding Economic and Social Research Council. Preregistration None. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01435-2.
Collapse
Affiliation(s)
- Benjamin Woolf
- Department of Psychological Science, University of Bristol, 5 Priory Road, Bristol, UK. .,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK. .,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Phil Edwards
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
9
|
Palmer NR, Borno HT, Gregorich SE, Livaudais-Toman J, Kaplan CP. Prostate cancer patients' self-reported participation in research: an examination of racial/ethnic disparities. Cancer Causes Control 2021; 32:1161-1172. [PMID: 34189651 PMCID: PMC8416807 DOI: 10.1007/s10552-021-01463-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/13/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE We examined prostate cancer patients' participation in research and associated factors by race/ethnicity in a multiethnic sample. METHODS Men with a new diagnosis of prostate cancer were identified through the California Cancer Registry. Patients completed a cross-sectional telephone interview in English, Spanish, Cantonese or Mandarin. Multivariable logistic regression models, stratified by race/ethnicity, estimated the associations of patient demographic and health characteristics with participation in (1) any research, (2) behavioral research, and (3) biological/clinical research. RESULTS We included 855 prostate cancer patients: African American (19%), Asian American (15%), Latino (24%), and White (42%). In the overall model of participation in any research, African American men (Odds Ratio (OR) = 2.54, 95% CI 1.63-3.94), and those with two or more comorbidities (OR = 2.20, 95% CI 1.27-3.80) were more likely to report participation. Men 65 years old and older (OR = 0.65, 95% CI 0.47-0.91), those who were married or living with a partner (OR = 0.67, 95% CI 0.45-0.98), and those who completed the interview in Spanish (OR = 0.36, 95% CI 0.15-0.85) were less likely to report participating in any research. Stratified analyses identified racial/ethnic-specific sociodemographic characteristics associated with lower research participation, including Spanish or Chinese language, older age, and lower education. CONCLUSION African American prostate cancer patients reported higher research participation than all other groups. However, recruitment efforts are still needed to overcome barriers to participation for Spanish and Chinese speakers, and barriers among older adults and those with lower education levels.
Collapse
Affiliation(s)
- Nynikka R Palmer
- Department of Medicine, Division of General Internal Medicine at Zuckerberg, San Francisco General Hospital, University of California San Francisco, UCSF, 1001 Potrero Avenue, Box 1364, San Francisco, CA, 94143, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, USA.
| | - Hala T Borno
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, USA
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, USA
| | - Steven E Gregorich
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, USA
- Multiethnic Research Center, University of California San Francisco, San Francisco, USA
| | - Jennifer Livaudais-Toman
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, USA
| | - Celia P Kaplan
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, USA
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, USA
- Multiethnic Research Center, University of California San Francisco, San Francisco, USA
| |
Collapse
|
10
|
Clinical impact of antipsychotic and benzodiazepine reduction: findings from a multicomponent psychotropic reduction program within long-term aged care. Int Psychogeriatr 2021; 33:587-599. [PMID: 32618535 DOI: 10.1017/s1041610220000940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To explore the relationships between dose changes to antipsychotic and/or benzodiazepine medications and resident outcomes, including variations in neuropsychiatric symptoms, quality of life (QoL), and social withdrawal, within a multicomponent, interdisciplinary antipsychotic and benzodiazepine dose reduction program. DESIGN Prospective, observational, longitudinal study. INTERVENTION The Reducing Use of Sedatives (RedUSe) project involved 150 Australian Long-Term Care Facilities (LTCFs) incorporating auditing and benchmarking of prescribing, education, and multidisciplinary sedative reviews. SETTING A convenience sample of LTCFs (n = 28) involved in RedUSe between January 2015 and March 2016. PARTICIPANTS Permanent residents (n = 206) of LTCFs involved in RedUSe taking an antipsychotic and/or benzodiazepine daily. Residents were excluded if they had a severe psychiatric condition where antipsychotic therapy should generally be maintained long-term (e.g., bipolar disorder, schizophrenia) or were considered end-stage palliative. MEASUREMENTS Neuropsychiatric symptoms (Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory (CMAI)), QoL (Assessment of Quality of Life-4D), and social withdrawal (Multidimensional Observation Scale for Elderly Subjects-withdrawal subscale) were measured at baseline and 4 months where nursing staff completed psychometric tests as proxy raters. RESULTS There was no evidence that psychometric measures were worsened following dose reductions. In fact, dose reduction was associated with small, albeit non-statistically significant, improvements in behavior, particularly less physically non-aggressive behavior with both drug groups (-0.36 points per 10% reduction in antipsychotic dose, -0.17 per 10% reduction in benzodiazepine dose) and verbally agitated behavior with benzodiazepine reduction (-0.16 per 10% dose reduction), as measured with the CMAI. Furthermore, antipsychotic reduction was associated with non-statistically significant improvements in QoL and social withdrawal. CONCLUSIONS Antipsychotic and benzodiazepine dose reduction in LTCFs was not associated with deterioration in neuropsychiatric symptoms, QoL, or social withdrawal. Trends toward improved agitation with antipsychotic and benzodiazepine dose reduction require further evaluation in larger, prospective, controlled studies.
Collapse
|
11
|
Greimel S, Wyman JF, Zhang L, Yu F. Recruitment and Screening Methods in Alzheimer's Disease Research: The FIT-AD Trial. J Gerontol A Biol Sci Med Sci 2021; 77:547-553. [PMID: 33780529 DOI: 10.1093/gerona/glab092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recruiting older adults with Alzheimer's disease (AD) dementia into clinical trials is challenging requiring multiple approaches. We describe recruitment and screening processes and results from the FIT-AD Trial, a single site, pilot randomized controlled trial testing the effects of a 6-month aerobic exercise intervention on cognition and hippocampal volume in community-dwelling older adults with mild-to moderate AD dementia. METHODS Ten recruitment strategies and a four-step screening process were used to ensure a homogenous sample and exercise safety. The initial target sample was 90 participants over 48 months which was increased to 96 to allow those in the screening process to enroll if qualified. A tertiary analysis of recruitment and screening rates, recruitment yields and costs, and demographic characteristics of participants was conducted. RESULTS During the 48-month recruiting period, 396 potential participants responded to recruitment efforts, 301 individuals were reached and 103 were tentatively qualified. Of these, 67 (69.8%) participants completed the optional magnetic resonance (MRI) imaging and seven were excluded due to abnormal MRI findings. As a result, we enrolled 96 participants with a 2.92 screen ratio, 2.14 recruitment rate, and 31.9% recruitment yield. Referrals (28.1%) and Alzheimer's Association events/services (21.9%) yielded over 49% of the enrolled participants. Total recruitment cost was $ 38,246 or $ 398 per randomized participant. CONCLUSIONS A multi-prong approach involving extensive community outreach was essential in recruiting older adults with AD dementia into a single-site trial. For every randomized participant, three individuals needed to be screened. Referrals were the most cost-effective recruitment strategy.
Collapse
Affiliation(s)
- Susan Greimel
- School of Nursing, University of Minnesota, Minneapolis, MN
| | - Jean F Wyman
- School of Nursing, University of Minnesota, Minneapolis, MN
| | - Lin Zhang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| |
Collapse
|
12
|
Heid AR, Cartwright FP, Wilson-Genderson M, Pruchno R. Understanding Attrition and Bolstering Retention in a Longitudinal Panel of Older Adults: ORANJ BOWL. Innov Aging 2021; 5:igab010. [PMID: 33898761 PMCID: PMC8054864 DOI: 10.1093/geroni/igab010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives Attrition from longitudinal studies can affect the generalizability of findings especially when studying developmental constructs such as successful aging. Research Design and Methods Using data from a 12-year (6-wave) panel of 5,688 older people (aged 50-74 at baseline), we compared people retained in the panel with people lost to follow-up on demographic characteristics and measures of successful aging. After instituting expanded retention strategies at Wave 6 (i.e., a team-based approach, social media, and paid web search engines), we compared different groups of people lost to follow-up (i.e., deceased and withdrawn due to lack of interest) and different types of completers (i.e., full completers vs. lost and reengaged completers). Results At baseline, Wave 6 completers were significantly younger, less likely to be African American, more likely to be married, reported higher levels of income and education, were more likely to be working full-time, had less pain and fewer chronic illnesses, and reported higher levels of subjective successful aging and functional ability than those lost to follow-up. Analyses demonstrated differences across groups based on the reason for loss (i.e., deceased, impaired, and not interested). Participants who missed an interview but returned to the panel were significantly different from those who participated in all waves of data collection. Expanded retention efforts improved generalizability, as people returning to the panel reported lower levels of education, lower levels of income, and were more likely to be African American. Discussion and Implications Biased attrition within longitudinal research affects the interpretation of study findings, especially when studying developmental outcomes. However, expanded retention strategies can reduce bias and loss and should be used to enhance retention efforts in longitudinal work.
Collapse
Affiliation(s)
| | - Francine P Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | | | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| |
Collapse
|
13
|
Forsat ND, Palmowski A, Palmowski Y, Boers M, Buttgereit F. Recruitment and Retention of Older People in Clinical Research: A Systematic Literature Review. J Am Geriatr Soc 2020; 68:2955-2963. [DOI: 10.1111/jgs.16875] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Noah D. Forsat
- Department of Rheumatology and Clinical Immunology Charité–University Medicine Berlin Berlin Germany
| | - Andriko Palmowski
- Department of Rheumatology and Clinical Immunology Charité–University Medicine Berlin Berlin Germany
| | - Yannick Palmowski
- Center for Musculoskeletal Surgery Charité–University Medicine Berlin Berlin Germany
| | - Maarten Boers
- Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology Charité–University Medicine Berlin Berlin Germany
| |
Collapse
|
14
|
Daley AJ, Jolly K, Bensoussane H, Ives N, Jebb SA, Tearne S, Greenfield SM, Yardley L, Little P, Tyldesley-Marshall N, Pritchett RV, Frew E, Parretti HM. Feasibility and acceptability of a brief routine weight management intervention for postnatal women embedded within the national child immunisation programme in primary care: randomised controlled cluster feasibility trial. Trials 2020; 21:757. [PMID: 32873323 PMCID: PMC7466790 DOI: 10.1186/s13063-020-04673-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of obesity in women continues to rise and pregnancy is a high-risk time for excessive weight gain. The period after childbirth represents an opportunity to offer women support to manage their weight. The primary aim here was to investigate the acceptability and feasibility of delivering a self-management intervention to postnatal women to support weight loss, embedded within the national child immunisation programme. METHODS The research involved a randomised controlled cluster feasibility trial. Data were collected at baseline and 3 months later. Twenty-eight postnatal women living with overweight or obesity were recruited via Birmingham Women Hospital or general practices. Babies are routinely immunised at 2, 3 and 4 months of age; the intervention was embedded within these appointments. The intervention involved brief motivation/support by practice nurses to encourage participants to make healthier lifestyle choices through self-monitoring of weight and signposting to an online weight management programme, when they attended their practice to have their child immunised. The role of the nurse was to provide external accountability for weight loss. Participants were asked to weigh themselves weekly and record this on a record card or using the online programme. The weight goal was for participants to lose 0.5 to 1 kg per week. Usual care received a healthy lifestyle leaflet. The primary outcome was the feasibility of a phase III trial to test the subsequent effectiveness of the intervention, as assessed against three stop-go traffic light criteria (recruitment, adherence to regular self-weighing and registration with an online weight management programme). RESULTS The traffic light stop-go criteria results were red for recruitment (28/80, 35% of target), amber for registration with the online weight loss programme (9/16, 56%) and green for adherence to weekly self-weighing (10/16, 63%). Nurses delivered the intervention with high fidelity. DISCUSSION Whilst participants and nurses followed the trial protocol well and adherence to self-weighing was acceptable, recruitment was challenging and there is scope to improve engagement with the online weight management programme component of the intervention. TRIAL REGISTRATION ISRCTN 12209332 . Registration date is 04/12/18.
Collapse
Affiliation(s)
- A J Daley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
| | - K Jolly
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - H Bensoussane
- Birmingham Clinical Trials Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - N Ives
- Birmingham Clinical Trials Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - S A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - S Tearne
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - S M Greenfield
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - L Yardley
- School of Psychological Science, University of Bristol, Bristol, BS8 1TH, UK.,Department of Psychology, University of Southampton, Southampton, S017 1BJ, UK
| | - P Little
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
| | - N Tyldesley-Marshall
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.,Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - R V Pritchett
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - E Frew
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - H M Parretti
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,Norwich Medical School, University of East Anglia, Norwich, Norfolk, NR4 7TJ, UK
| |
Collapse
|
15
|
Gill TM, McGloin JM, Shelton A, Bianco LM, Skokos EA, Latham NK, Ganz DA, Nyquist LV, Wallace RB, Carnie MB, Dykes PC, Goehring LA, Doyle M, Charpentier PA, Greene EJ, Araujo KL. Optimizing Retention in a Pragmatic Trial of Community-Living Older Persons: The STRIDE Study. J Am Geriatr Soc 2020; 68:1242-1249. [PMID: 32212395 DOI: 10.1111/jgs.16356] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study is testing the effectiveness of a multifactorial intervention to prevent serious fall injuries. Our aim was to describe procedures that were implemented to optimize participant retention; report retention yields by age, sex, clinical site, and follow-up time; provide reasons for study withdrawals; and highlight the successes and lessons learned from the STRIDE retention efforts. DESIGN Pragmatic cluster randomized trial. SETTING A total of 86 primary care practices within 10 US healthcare systems. PARTICIPANTS A total of 5451 community-living persons, 70 years of age or older, at high risk for serious fall injuries. MEASUREMENTS Study outcomes were collected every 4 months by a central call center. Reconsent was required to extend follow-up beyond the originally planned 36 months. RESULTS Over a median follow-up of 3.2 years (interquartile range = 2.8-3.7 y), 439 (8.1%) participants died and 600 (11.0%) withdrew their consent or did not reconsent to extend follow-up beyond 36 months, yielding rates (per 100 person-years) of deaths and withdrawals of 2.6 and 3.6, respectively. The withdrawal rate increased with advancing age, was comparable for men and women, and did not differ much by clinical site. The most common reasons for withdrawal were illness and unable to contact for reconsent at 36 months. Completion of the follow-up interviews was greater than 93% at each time point. Most participants completed all (71.8%) or all but one (9.2%) of the follow-up interviews. The most common reason for not completing a follow-up interview was unable to contact, with rates ranging from 2.8% at 40 months to 4.6% at 20 months. CONCLUSION Completion of the thrice-yearly follow-up interviews in STRIDE was high, and retention of participants over 44 months exceeded the original projections. The procedures used in STRIDE, together with lessons learned, should assist other investigators who are planning or conducting large pragmatic trials of vulnerable older persons. J Am Geriatr Soc 68:1242-1249, 2020.
Collapse
Affiliation(s)
- Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Joanne M McGloin
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Amy Shelton
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Luann M Bianco
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Eleni A Skokos
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | | | - David A Ganz
- Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School of Medicine at UCLA, Los Angeles, California.,VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Linda V Nyquist
- Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | | | | | | | | | - Margaret Doyle
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Peter A Charpentier
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Erich J Greene
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Katy L Araujo
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| |
Collapse
|
16
|
Partha Sarathy P, Kottam L, Parker A, Brealey S, Coleman E, Keding A, Mitchell A, Northgraves M, Torgerson D, Rangan A. Timing of electronic reminders did not improve trial participant questionnaire response: a randomized trial and meta-analyses. J Clin Epidemiol 2020; 122:70-77. [PMID: 32151697 DOI: 10.1016/j.jclinepi.2020.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/18/2020] [Accepted: 03/03/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The objective of this study was to assess whether timing of short messaging service (SMS) reminders improved postal questionnaire return rates from participants in a randomized controlled trial (RCT). STUDY DESIGN AND SETTING A Study Within A Trial (SWAT) embedded in a multicenter RCT evaluating three treatments for the frozen shoulder. Participants who provided a mobile telephone number were randomized to either prenotification SMS on the day of the questionnaire mail-out or postnotification SMS 4 days after questionnaire mail-out for the 3-month follow-up. The primary outcome was the proportion of participants who returned a valid questionnaire. A systematic review was undertaken to identify other embedded trials to perform a meta-analysis. RESULTS Of the 269 participants, 122/135 (90.4%) returned a valid questionnaire in the prenotification arm and 119/134 (88.8%) in the postnotification arm (difference of -1.6%; 95% CI of difference: -8.9%, 5.7%). There was no difference in time to response (HR = 1.04; 95% CI: 0.80 to 1.34) or need for additional reminders (OR = 0.71; 95% CI: 0.43 to 1.17). Meta-analysis of two RCTs showed no difference in response rates between prenotification and postnotification reminders (OR = 0.78 95% CI: 0.42 to 1.45). CONCLUSION Timing of SMS reminders did not improve response rates and time to response or affect the need for additional reminders.
Collapse
Affiliation(s)
- Prasanna Partha Sarathy
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - Lucksy Kottam
- STRIVE, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough, TS4 3BW, UK
| | - Adwoa Parker
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - Stephen Brealey
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK.
| | - Elizabeth Coleman
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - Ada Keding
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - Alex Mitchell
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - Matthew Northgraves
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK
| | - Amar Rangan
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, UK; STRIVE, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough, TS4 3BW, UK
| |
Collapse
|
17
|
Saito H, Shodo R, Yamazaki K, Katsura K, Ueki Y, Nakano T, Oshikane T, Yamana N, Tanabe S, Utsunomiya S, Ohta A, Abe E, Kaidu M, Sasamoto R, Aoyama H. The association between oral candidiasis and severity of chemoradiotherapy-induced dysphagia in head and neck cancer patients: A retrospective cohort study. Clin Transl Radiat Oncol 2019; 20:13-18. [PMID: 31737796 PMCID: PMC6849117 DOI: 10.1016/j.ctro.2019.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/21/2019] [Accepted: 10/26/2019] [Indexed: 11/27/2022] Open
Abstract
Oral candidiasis (OC) aggravated dysphagia in chemoradiation for HNC. OC patients required higher doses of opioids. Early diagnosis of chemoradiation-associated OC seems difficult. Antifungal prophylaxis may reduce the severity of mucositis and dysphagia.
Background and purpose Concurrent chemoradiotherapy (CCRT) for head and neck cancer (HNC) is a risk factor for oral candidiasis (OC). As Candida spp. are highly virulent, we conducted a retrospective study to determine whether OC increases the severity of dysphagia related to mucositis in HNC patients. Patients and methods We retrospectively analyzed the cases of consecutive patients with carcinomas of the oral cavity, pharynx, and larynx who underwent CCRT containing cisplatin (CDDP) at our hospital. The diagnosis of OC was based on gross mucosal appearance. We performed a multivariate analysis to determine whether OC was associated with the development of grade 3 dysphagia in the Radiation Therapy Oncology Group (RTOG) Acute Toxicity Criteria. The maximum of the daily opioid doses was compared between the patients with and without OC. Results We identified 138 HNC patients. OC was observed in 51 patients (37%). By the time of their OC diagnosis, 19 (37%) had already developed grade 3 dysphagia. Among the 30 patients receiving antifungal therapy, 12 (40%) showed clinical deterioration. In the multivariate analysis, OC was independently associated with grade 3 dysphagia (OR 2.75; 95%CI 1.22–6.23; p = 0.015). The patients with OC required significantly higher morphine-equivalent doses of opioids (45 vs. 30 mg/day; p = 0.029). Conclusion Candida infection causes refractory dysphagia. It is worth investigating whether antifungal prophylaxis reduces severe dysphagia related to candidiasis.
Collapse
Affiliation(s)
- Hirotake Saito
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Ryusuke Shodo
- Departments of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Keisuke Yamazaki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Kouji Katsura
- Department of Oral Radiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Yushi Ueki
- Departments of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Tomoya Oshikane
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Nobuko Yamana
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8520, Japan
| | - Satoru Utsunomiya
- Department of Radiologic Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Eisuke Abe
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Motoki Kaidu
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| | - Ryuta Sasamoto
- Department of Radiologic Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| | - Hidefumi Aoyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata 951-8510, Japan
| |
Collapse
|
18
|
A systematic review of pharmacists' interventions to support medicines optimisation in patients with visual impairment. Int J Clin Pharm 2019; 41:1400-1407. [PMID: 31531815 DOI: 10.1007/s11096-019-00907-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/07/2019] [Indexed: 01/17/2023]
Abstract
Background People with visual impairment often report poorer health and encounter many challenges when using medicines. Pharmacists can play a significant role in optimising medicines use for these patients. However, little is known about pharmacists' current practices when providing services to this population nor the impact of such services, if any, on medicines optimisation-related outcomes. Aim of the review This systematic review aims to identify the types, and assess the effectiveness of, interventions provided by pharmacists on medicines optimisation-related outcomes. Method Systematic searches of the following electronic databases were carried out from date of inception to March 2018: Cochrane Library; MEDLINE; EMBASE; International Pharmaceutical Abstracts; Scopus; and Cumulative Index to Nursing and Allied Health Literature. Several trial registries and grey literature resources were also searched. Any randomised controlled trials, non-randomised controlled trials, controlled before-and-after studies, or interrupted time series analyses reporting on interventions provided by pharmacists to adult visually impaired patients and/or their caregivers in order to improve medicines optimisation-related outcomes of medicine safety, adherence, patient satisfaction, shared decision making, or quality of life were included. Results A total of 1877 titles/abstracts were screened, and 27 full text articles were assessed for eligibility. On examination of full texts, no studies met the inclusion criteria for this review. Conclusion This review highlights the need for future research that would be vital for promoting the safe and effective use of medicines and the delivery of pharmaceutical care services to people with visual impairment.
Collapse
|
19
|
Banack HR, Kaufman JS, Wactawski-Wende J, Troen BR, Stovitz SD. Investigating and Remediating Selection Bias in Geriatrics Research: The Selection Bias Toolkit. J Am Geriatr Soc 2019; 67:1970-1976. [PMID: 31211407 PMCID: PMC9930538 DOI: 10.1111/jgs.16022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 04/05/2019] [Accepted: 05/15/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Selection bias is a well-known concern in research on older adults. We discuss two common forms of selection bias in aging research: (1) survivor bias and (2) bias due to loss to follow-up. Our objective was to review these two forms of selection bias in geriatrics research. In clinical aging research, selection bias is a particular concern because all participants must have survived to old age, and be healthy enough, to take part in a research study in geriatrics. DESIGN We demonstrate the key issues related to selection bias using three case studies focused on obesity, a common clinical risk factor in older adults. We also created a Selection Bias Toolkit that includes strategies to prevent selection bias when designing a research study in older adults and analytic techniques that can be used to examine, and correct for, the influence of selection bias in geriatrics research. RESULTS Survivor bias and bias due to loss to follow-up can distort study results in geriatric populations. Key steps to avoid selection bias at the study design stage include creating causal diagrams, minimizing barriers to participation, and measuring variables that predict loss to follow-up. The Selection Bias Toolkit details several analytic strategies available to geriatrics researchers to examine and correct for selection bias (eg, regression modeling and sensitivity analysis). CONCLUSION The toolkit is designed to provide a broad overview of methods available to examine and correct for selection bias. It is specifically intended for use in the context of aging research. J Am Geriatr Soc 67:1970-1976, 2019.
Collapse
Affiliation(s)
- Hailey R. Banack
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York
| | - Jay S. Kaufman
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York
| | - Bruce R. Troen
- Division of Geriatrics and Palliative Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo and Research Service, Veterans Affairs Western New York Healthcare System, Buffalo, New York
| | - Steven D. Stovitz
- Department of Family Medicine and Community Health, University of Minnesota System, Minneapolis, Minnesota
| |
Collapse
|
20
|
Bongers KTJ, Schoon Y, Olde Rikkert MGM. Self-management tasks to improve mobility and reduce fall risk are not leading to lower research participation in older adults. Arch Gerontol Geriatr 2018; 78:14-17. [PMID: 29883804 DOI: 10.1016/j.archger.2018.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 05/25/2018] [Accepted: 05/30/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE OF STUDY The first aim is to evaluate, in a sub-study, the recruitment process of the Senior Step Study, which was an intervention study on the self-management of mobility and fall risk; the second aim is to explore the reasons mentioned by older people, from three different settings, for (not) participating. METHODS Subjects were community-dwelling older persons, residents of homes for the elderly, and older persons regularly visiting community centres. The effectiveness of different recruitment procedures was analysed for each setting separately. We also analysed reasons for accepting and declining participation between the settings. RESULTS The total inclusion rate was 27.9%. A personal initial approach (i.e., first contact was face-to-face or in a group meeting) did not improve the inclusion rate. More subjects consented to participate after an introductory meeting (which was planned after the first face-to-face contact) compared to persons not having one (p < 0.01). At different settings, subjects gave different reasons for participation. No differences were found in the reasons for refusing participation. Especially in homes for the elderly, people refused to participate because the research was too burdensome. CONCLUSIONS The inclusion rates in this study are comparable to other self-management studies with older people. An introductory meeting during which the study design and benefits of participating are explained and formal interim evaluations of the recruitment process may benefit recruitment. Recruiting older persons for self-management tasks is possible with the appropriate recruitment process, enabling more research on this increasingly important research topic.
Collapse
Affiliation(s)
- Kim T J Bongers
- Radboud University Medical Center, Department of Geriatric Medicine, Post Office Box 9101, NL, 6500 HB, Nijmegen, The Netherlands
| | - Yvonne Schoon
- Radboud University Medical Center, Department of Geriatric Medicine, Post Office Box 9101, NL, 6500 HB, Nijmegen, The Netherlands.
| | - Marcel G M Olde Rikkert
- Radboud University Medical Center, Department of Geriatric Medicine, Post Office Box 9101, NL, 6500 HB, Nijmegen, The Netherlands
| |
Collapse
|
21
|
Al-Allaq T, Feng C, Saunders RH. Anterior tooth wear and quality of life in a nursing home population. SPECIAL CARE IN DENTISTRY 2018; 38:187-190. [PMID: 29741799 DOI: 10.1111/scd.12291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The aim of the study was to assess the extent to which a relationship may exist between the wear of the anterior teeth and quality of life in a population of nursing home residents. METHODS AND RESULTS A population (n = 100) of nursing home residents (mean age 75.7 years) was recruited all members of which had at least 4 upper and 4 lower anterior teeth and were assessed as cognitively intact by nursing personnel who were familiar with their behavior. The investigator evaluated the level of tooth wear of each subject according to the Tooth Wear Index of Donachie and Walls (Adapted) and then verbally administered the Geriatric Oral Health Assessment Index (GOHAI) of Atchison and Dolan. Analyses did not reveal significant differences in tooth wear between males and females nor between age and GOHAI score; however, tooth wear was positively related to age and inversely related to quality of life. CONCLUSIONS Results suggest that tooth wear is negatively related to quality of life.
Collapse
Affiliation(s)
- Tumouh Al-Allaq
- Eastman Institute for Oral Health, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Changyong Feng
- Eastman Institute for Oral Health, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Ralph H Saunders
- Eastman Institute for Oral Health, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| |
Collapse
|
22
|
Hamaker ME, Prins M, van Huis LH. Update in geriatrics: What geriatric oncology can learn from general geriatric research. J Geriatr Oncol 2018; 9:393-397. [PMID: 29396236 DOI: 10.1016/j.jgo.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 12/27/2017] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
Abstract
Life expectancy has been steadily increasing for decades and this trend is likely to continue in coming years. In fact, there is more than a 50% probability that by 2030 female life expectancy could break the 90 year barrier, with more than half of the expected gains due to enhanced longevity above the age of 65 years. The resultant aging of societies means that health care will be faced with a rising number of increasingly older patients, who are also likely to have higher levels of multimorbidity. Most issues regarding assessment, prognostication and, management of older patients are not unique to geriatric oncology and thus there is opportunity to learn from progress in other fields. The purpose of this paper is to provide an update on research, reviews, and debate in general geriatrics that may be relevant to clinicians and researchers active in geriatric oncology. The selection of topics was based on a general search of the table of contents of widely read geriatrics and internal medicine journals, and includes geriatric co-management, improving research for older patients, caregiver issues, eliciting patient preferences, and shared-decision making.
Collapse
Affiliation(s)
- Marije E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis Utrecht/Zeist, The Netherlands.
| | - Meike Prins
- Department of Geriatric Medicine, Diakonessenhuis Utrecht/Zeist, The Netherlands
| | - Lieke H van Huis
- Department of Internal Medicine, Diakonessenhuis Utrecht/Zeist, The Netherlands
| |
Collapse
|