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An investigation of practice and practitioner factors that influence the recruitment of patients to primary care based randomised controlled trials: case study of the Birmingham Atrial Fibrillation Treatment of the Aged (BAFTA) study

Fletcher, Kate Elizabeth (2012)
Ph.D. thesis, University of Birmingham.

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Patient recruitment to trials is problematic; many fail to achieve targets, leaving them underpowered and unable to address their hypothesis. Few solutions have been identified in existing literature. This thesis aimed to: identify factors associated with recruitment; and
understand clinicians’ experiences of recruiting patients to a primary care based randomised controlled trial (RCT). This was explored using The Birmingham Atrial Fibrillation
Treatment of the Aged (BAFTA) trial as a case study.

Mixed methods were used: a systematic review to identify factors influencing recruitment to primary care based RCTs; quantitative analysis of BAFTA data to identify factors associated with recruitment; and qualitative interviews with General Practitioners involved with BAFTA, to understand their experience of participation.

Existing literature demonstrated that influences on recruitment include: study workload; study question; concerns about patients. Recommendations to address these issues are not based on strong empirical evidence. BAFTA identified factors associated with patient recruitment
(practice size; GP age; recruitment year); and patterns over time. Interviews identified differences in attitude between high and low recruiters, including risk perception and motivation.

This thesis demonstrates how practitioners can influence patient recruitment. Revised recruitment methods need testing in prospective trials.

Type of Work:Ph.D. thesis.
Supervisor(s):Mant, Jonathan and Lester, Helen
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Health and Population Sciences
Subjects:H Social Sciences (General)
Q Science (General)
Institution:University of Birmingham
ID Code:3519
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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