Recruiters to randomised trials can be trained to facilitate recruitment and informed consent by exploring patients’ treatment preferences
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KeywordsPublic Health Informed Consent Randomise Control Trial Randomise Trial Patient Preference
Patient preferences for treatments are often cited as barriers to recruitment in randomised controlled trials (RCTs) but little is known about how to approach this issue in the context of trial recruitment. We investigated how recruitment staff reacted to patients’ treatment preferences within three different pragmatic RCTs.
Audio-recordings of 85 RCT recruitment appointments with 69 participants in three UK multicentre RCTs were analysed using content and thematic analysis. Recruiters’ responses to treatment preferences were assessed in one RCT (ProtecT), where training on exploring preferences was given, and compared with two other RCTs where this type of specific training was not given.
Recruiters elicited treatment preferences similarly in all RCTs, but responses to them differed substantially. In the ProtecT RCT, recruiters explored participants’ preferences at length in four key ways: eliciting and acknowledging the preference rationale, balancing treatment views, empathising with the situation, and emphasising the need to keep an open mind and consider all treatments. Conversely in the other RCTs, treatment preferences were usually accepted by recruiters with little discussion and few patients randomised.
Recruiters can be trained to elicit and address patients’ treatment preferences enabling those who may not have considered trial participation to do so. Training interventions for recruiters are required to facilitate recruitment and informed consent.
We acknowledge the study funders (MRC ConDuCT Trials Methodology Hub, NIHR HTA and RfPB), all participating clinicians and patients, and the CIs and PIs of the trials.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.