DOI: 10.5061/dryad.4dg4v0c8
title: Data from: Improving the recruitment activity of clinicians in randomised controlled trials - a systematic review

description: BACKGROUND: Poor recruitment to randomised controlled trials (RCTs) is a
 widespread problem. Provision of interventions aimed at supporting or
 incentivising clinicians may improve recruitment to RCTs. OBJECTIVES: To
 quantify the effects of strategies aimed at improving the recruitment
 activity of clinicians in RCTs, complemented with a synthesis of
 qualitative evidence related to clinicians’ attitudes towards recruiting
 to RCTs. DATA SOURCES: A systematic review of English and non-English
 articles identified from: The Cochrane Library, Ovid MEDLINE, Ovid EMBASE,
 Ovid PsycINFO, Ebsco CINAHL, Index to Theses and Open SIGLE from 2001 to
 March 2011. Additional reports were identified through citation searches
 of included articles. STUDY ELIGIBILITY CRITERIA: Quantitative studies
 were included if they evaluated interventions aimed at improving the
 recruitment activity of clinicians, or compared recruitment by different
 groups of clinicians. Information about host trial, study design,
 participants, interventions, outcomes and host RCT was extracted by one
 researcher and checked by another. Studies that met the inclusion criteria
 were assessed for quality using a standardised tool; the Effective Public
 Health Practice Project (EPHPP) tool. Qualitative studies were included if
 they investigated clinicians’ attitudes to recruiting patients to RCTs.
 All results/findings were extracted and content analysis was carried out.
 Overarching themes were abstracted, followed by a metasummary analysis.
 Studies that met the inclusion criteria were assessed for quality using
 the Critical Appraisal Skills Programme (CASP) qualitative checklist. DATA
 EXTRACTION: Data extraction was carried out by one researcher using
 predefined data fields, including study quality indicators, and verified
 by another. RESULTS: Eight quantitative studies were included describing
 four interventions and a comparison of recruiting-clinicians. One study
 was rated as strong, one as moderate and the remaining six as weak when
 assessed for quality using the EPHPP tool. Effective interventions
 included: the use of qualitative research to identify and overcome
 barriers to recruitment; reduction of the clinical workload associated
 with participation in RCTs; and the provision of extra training and
 protected research time. Eleven qualitative studies were identified and
 eight themes were abstracted from the data: understanding of research;
 communication; perceived patient barriers; patient-clinician relationship;
 effect on patients; effect on clinical practice; individual benefits for
 clinicians; and methods associated with successful recruitment.
 Metasummary analysis identified the most frequently reported sub-themes to
 be: difficulty communicating trial methods; poor understanding of
 research; and priority given to patient wellbeing. Overall, the
 qualitative studies were found to be of good quality when assessed using
 the CASP checklist. CONCLUSIONS: There were few high quality trials that
 tested interventions to improve clinicians’ recruitment activity in RCTs.
 The most promising intervention was the use of qualitative methods to
 identify and overcome barriers to clinician recruitment activity. More
 good quality studies of interventions are needed to add to the evidence
 base. The metasummary of qualitative findings identified understanding and
 communicating RCT methods as a key target for future interventions to
 improve recruitment. Reinforcement of the potential benefits, both for
 clinicians and their patients, could also be a successful factor in
 improving recruitment. A bias was found toward investigating barriers to
 recruitment, so future work should also encompass a focus on successfully
 recruiting trials.
description: PRISMA checklist
 BF18112011PRISMA
 checklistBMJ Open submission
 supplementary material BF18112011Supplementary materials.
 Quality assessment and data extraction for included studies; qualitative
 findings, and example search strategy.