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‘Recruitment, recruitment, recruitment’ – the need for more focus on retention: a qualitative study of five trials

机译：“招聘，招聘，招聘” –需要更多地关注保留：对五项试验的定性研究

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Loss to follow-up (attrition) is a frequent problem in clinical trials and can introduce bias or reduce power. So, understanding retention issues and strategies to address these are important. As part of a multi-method project, this qualitative study aimed to explore retention strategies used by trial teams and factors which may influence strategy adoption. A purposive sample of active trials was selected from the UK NIHR HTA portfolio of ongoing trials in 2014/2015. Semi-structured interviews with several trial team members from each trial and supplementary interviews with experienced trial managers explored strategies in collecting clinical outcome data and retaining participants. Interview data were analysed thematically using techniques of constant comparison. Twenty-two semi-structured interviews with trial team members including chief investigators, trial managers, nurses and research administrators revealed strategies used to enhance retention. Some were recognised methods and planned from trial outset whilst others were implemented more responsively. Interviewees placed great value on fostering positive relationships with trial participants to enhance retention. However, these strategies took time which was not always appreciated by the wider trial team or funding bodies. The national focus on recruitment targets in networks posed a challenge to staff and was deemed detrimental to retention. The ‘moral compass’ of individual researchers relied on their own beliefs and values and research experience and the factors affected their confidence to pursue participant data during follow-up. The role of trial staff and their underlying behaviours influence retention practices and, combined with emphasis on recruitment targets, can be detrimental to motivation and retention activities. There is a need to consider how to train and support trial staff involved in retention practices and recognition of retention from funding bodies and oversight organisations.
机译：失去随访（耗损）是临床试验中经常遇到的问题，并且可能导致偏见或降低能力。因此，了解保留问题和解决这些问题的策略很重要。作为多方法项目的一部分，此定性研究旨在探讨试验团队使用的保留策略和可能影响策略采用的因素。从2014/2015年英国NIHR HTA正在进行的试验组合中选择了一项主动试验的有目的样本。与每个试验的几个试验组成员进行的半结构化访谈，以及对经验丰富的试验管理人员的补充访谈，探讨了收集临床结果数据并保留参与者的策略。访谈数据使用恒定比较技术进行了主题分析。对包括主要研究人员，试验管理人员，护士和研究管理人员在内的试验团队成员进行的22次半结构化访谈揭示了用于提高保留率的策略。有些是公认的方法，从一开始就已计划好，而另一些则响应更快。受访者非常重视与试验参与者建立积极关系，以提高保留率。但是，这些策略需要花费时间，而广大的审判团队或资助机构并不总是很欣赏这些策略。国家对网络中征聘目标的重视对工作人员构成了挑战，并被认为不利于保留。个别研究人员的“道德指南针”依赖于他们自己的信念，价值观和研究经验，这些因素影响了他们在随访期间追踪参与者数据的信心。试验人员的角色及其基本行为会影响保留做法，再加上对招聘目标的强调，可能会不利于激励和保留活动。有必要考虑如何培训和支持参与保留做法的审判工作人员，以及如何从资助机构和监督组织中确认保留。

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