Recruitment and Coaching of Healthy Elderly Subjects for Invasive Cardiovascular Research with Right-Sided Catheterisation

Bos, Anja; Remmen, Jaap J.; Aengevaeren, W.R.M.; Verheugt, Freek W. A.; Hoefnagels, W.H.L.; Jansen, René W. M. M.

doi:10.1016/s1474-51510200046-4

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…Seven studies (14%) reported that, before inclusion, their participants were informed about a payment ranging from "a small honorarium" 44 to payments above $110. 48,49 One study could only provide $5 to their participants but, in the authors' opinion, their participation rate would have been higher if the payment had been better. 44 Even though in one study incentives of about $125 were paid and in another study gift certificates of $50 were offered, the authors could not confirm that the payment had a significant impact on the willingness of individuals to participate.…”

Section: Strategies To Recruit Higher Numbers Of Older Adults Into CLmentioning

confidence: 99%

Recruitment and Retention of Older People in Clinical Research: A Systematic Literature Review

Forsat

Palmowski

et al. 2020

J American Geriatrics Society

111

100

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OBJECTIVE To identify barriers and solutions for the recruitment and retention of older (aged ≥65 years) people in clinical trials. DESIGN Systematic literature review. METHODS Three databases (Medline, Embase, and CENTRAL) were searched for articles reporting on barriers or solutions regarding the recruitment or retention of older people. Only original research articles were included. RESULTS Fifty eligible articles were identified. Exclusion criteria were the most common cause of poor recruitment of older adults (mainly age and comorbidities). Patients' families or physicians often advised against participation (22% of included studies). Lack of interest (18%) and problems with transportation (18%) were also commonly cited as challenges. Fourteen trials (28%) reported that monitoring and adapting their recruitment methods helped, along with a flexible research team (26%) and provision of transportation (24%). Retention was impaired by death (12%), illness (8%), and loss of interest (6%). Methods with a positive effect on retention included financial incentives and regular information about the progress of the study (12%), a low staff turnover (12%), flexibility in appointment making (10%), and expression of appreciation by the staff through letters, gifts, and cards to the participants (10%). CONCLUSION We identified several barriers and have listed potential solutions that may improve recruitment and lead to fewer dropouts in trials involving older populations. Implementation of our findings may help mitigate the manifold challenges that come with running a trial with older people.

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Section: Strategies To Recruit Higher Numbers Of Older Adults Into CLmentioning

confidence: 99%

Recruitment and Retention of Older People in Clinical Research: A Systematic Literature Review

Forsat

Palmowski

et al. 2020

J American Geriatrics Society

111

100

View full text Add to dashboard Cite

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“…Suitable volunteers were invited to the outpatient clinic to undergo a screening programme consisting of medical history, physical examination, electrocardiography, blood laboratory analysis, bedside spirometry, bicycle stress‐electrocardiography and echocardiography. The recruitment of the subjects was described in a previous report (Bos et al. , 2002).…”

Section: Methodsmentioning

confidence: 99%

Normal values of pulmonary capillary wedge pressure and the blood pressure response to the Valsalva manoeuvre in healthy elderly subjects

Remmen¹,

Aengevaeren²,

Verheugt³

et al. 2005

Clin Physio Funct Imaging

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The blood pressure response to the Valsalva manoeuvre is related to pulmonary capillary wedge pressure (PCWP) and can be used to diagnose heart failure. However, this has never been studied specifically in the elderly, in whom the prevalence of heart failure is highest. Furthermore, normal values of the Valsalva manoeuvre are lacking. We aimed to obtain normal values of PCWP and the blood pressure response to the Valsalva manoeuvre in elderly subjects. Therefore, 28 healthy subjects, aged 70 +/- 4 years, performed Valsalva manoeuvres before and after anti-G garment inflation, which was used for temporary increase of PCWP. Before inflation, PCWP was 9.8 +/- 1.9 mmHg in supine and 8.9 +/- 2.1 in semi-recumbent position. From the blood pressure response, measured with Finapres, the systolic blood pressure ratio (SBPR), pulse pressure ratio (PPR), stroke volume ratio (SVR) and heart rate ratio (HRR) were calculated. In supine position, SBPR was 0.76 +/- 0.11, PPR 0.51 +/- 0.16, SVR 0.42 +/- 0.11, and HRR 1.17 +/- 0.12. Semi-recumbently, SBPR was 0.74 +/- 0.10, PPR 0.46 +/- 0.14, SVR 0.41 +/- 0.10, and HRR 1.24 +/- 0.23. After inflation of the anti-G garment, the areas under the Receiver Operator Characteristics curves of SBPR, PPR and SVR for elevated (> or = 15 mmHg) PCWP were >0.85 in supine position. In conclusion, this is the first study to obtain normal values of the blood pressure response to the Valsalva manoeuvre and PCWP in healthy elderly subjects, which is essential for the interpretation of patient data. The Valsalva manoeuvre showed significant discriminatory power in the detection of elevated PCWP, which underscores its potential in the non-invasive diagnosis of heart failure.

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“…, 1992). In extension to these reports, we investigated the relationship of PCWP and the BP response to the Valsalva manoeuvre in healthy elderly subjects (Bos et al. , 2002), in order to get insight into the physiological BP response to the Valsalva manoeuvre and to obtain normal values.…”

Section: Introductionmentioning

confidence: 99%

Lower body positive pressure by anti‐G garment inflation: a suitable method to increase pulmonary capillary wedge pressure in healthy elderly subjects

Remmen¹,

Aengevaeren²,

Verheugt³

et al. 2005

Clin Physio Funct Imaging

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In a study on non-invasive assessment of pulmonary capillary wedge pressure (PCWP), we sought a method to increase PCWP non-invasively. We hypothesized that inflation of an anti-G garment was suitable to increase PCWP non-invasively in healthy elderly subjects. In 20 subjects, aged 70 +/- 4 years (mean +/- SD), before, immediately after, and 4 min after anti-G garment inflation to 52 mmHg, PCWP and mean pulmonary artery pressure (MPAP) were measured with a Swan-Ganz catheter, and mean arterial blood pressure (MAP) with Finapres, in supine and semi-recumbent position. Supine, PCWP (mmHg, mean +/- SD) increased from 9.9 +/- 2.1 to 15.5 +/- 3.9** immediately after inflation and 13.4 +/- 3.7** at 4 min; semi-recumbent from 8.9 +/- 2.0 to 17.5 +/- 3.3** and 14.7 +/- 2.9** (*P<0.05, **P< 0.001 versus before inflation). MPAP (mmHg) increased after inflation: supine 16.9 +/- 2.3 to 22.3 +/- 4.6** and 20.6 +/- 3.9** and semi-recumbent 15.7 +/- 2.8 to 24.3 +/- 5.1** and 22.5 +/- 3.5**, suggesting that increased preload was the primary effect of anti-G garment inflation. Supine MAP (mmHg) increased from 96.0 +/- 11.3 to 101.4 +/- 13.4** and 100.5 +/- 12.7* and semi-recumbent from 102.0 +/- 8.9 to 108.3 +/- 11.4** and 106.0 +/- 11.3*, suggesting an effect of increased afterload as well. The latter was supported by an increase in total peripheral resistance (d s cm(-5)) from 1346 +/- 299 to 1441 +/- 384 after 4 min (P = 0.057) and from 1461 +/- 341 to 1532 +/- 406 (P = 0.054), supine and semi-recumbent respectively, while cardiac output remained unchanged. Complications did not occur. We conclude that in healthy elderly subjects, anti-G garment inflation is a safe, non-invasive, method to induce a significant increase in PCWP. Our findings justify its application in future studies in which non-invasive temporary increase in PCWP is required.

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Recruitment and Coaching of Healthy Elderly Subjects for Invasive Cardiovascular Research with Right-Sided Catheterisation

Cited by 4 publications

References 28 publications

Recruitment and Retention of Older People in Clinical Research: A Systematic Literature Review

Recruitment and Retention of Older People in Clinical Research: A Systematic Literature Review

Normal values of pulmonary capillary wedge pressure and the blood pressure response to the Valsalva manoeuvre in healthy elderly subjects

Lower body positive pressure by anti‐G garment inflation: a suitable method to increase pulmonary capillary wedge pressure in healthy elderly subjects

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