Recruiting older adults for clinical trials

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Abstract

More than 400 community-dwelling older adults were recruited into a clinical trial which compared the effectiveness of diagnosis and treatment through geriatric assessment with that provided through usual community physician care. Six recruitment methods were utilized: referrals, solicitations, presentations, media, mailings, and fliers. Each method is described and its results reported in terms of numbers recruited, yield, and cost per participant. The most efficient method was referrals; the method producing the largest number was presentations; the least effective method was fliers. Problems and solutions are discussed, and guidelines for recruiting older adults are suggested. These guidelines include: monitoring with accompanying adaptation, targeting the groups most likely to benefit, providing incentives, and reducing uncertainty among potential participants.

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      A ‘comprehensive data-monitoring process with the capability of rapid feedback’ has been advised that should allow for ‘considering alternative strategies if recruitment is lagging’ [6]. We would therefore expect the utility of monitoring accrual to be pronounced if diverse recruitment methods are available, in particular if their efficiency is disparate or unclear [4,8,9,59,60]. The insight that ‘unanticipated difficulties are highly likely at some time’ generally calls for a ‘proactive approach to monitoring ongoing trials’ [3].

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    Support for this work provided by the National Institute on Aging grant HCT 5 R01 AG08276, and the Howard Heinz Endowment.

    J. Adams' former address was Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.

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