Site-specific factors associated with clinical trial recruitment efficiency in general practice settings: a comparative descriptive analysis

Abstract

Background Recruitment of participants is crucial to the success of randomised control trials (RCTs) but can be challenging and expensive. Current research on trial efficiency is often focused at the patient-level with an emphasis on effective recruitment strategies. Less is known about selection of study sites to optimise recruitment. We examine site-level factors that are associated with patient recruitment and cost efficiency using data from an RCT conducted across 25 general practices (GP) in Victoria, Australia. Methods Data on number of participants screened, excluded, eligible, recruited, and randomised from each study site were extracted from a clinical trial. Details regarding site characteristics, recruitment practices, and staff time commitment were collected using a three-part survey. The key outcomes assessed were recruitment efficiency (ratio of screened to randomised), average time, and cost for each participant recruited and randomised. To identify practice-level factors associated with efficient recruitment and lower cost, outcomes were dichotomised (25th percentile vs others) and each practice-level factor assessed against the outcomes to determine its association. Results Across 25 GP study sites, 1968 participants were screened of which 299 (15.2%) were recruited and randomised. The mean recruitment efficiency was 7.2, varying from 1.4 to 19.8 across sites. The strongest factor associated with efficiency was assigning clinical staff to identify potential participants (57.14% vs. 22.2%). The more efficient sites were smaller practices and were more likely to be rural locations and in areas of lower socioeconomic status. The average time used for recruitment was 3.7 h (SD2.4) per patient randomised. The mean cost per patient randomised was $277 (SD161), and this varied from $74 to $797 across sites. The sites identified with the 25% lowest recruitment cost (n = 7) were more experienced in research participation and had high levels of nurse and/or administrative support. Conclusion Despite the small sample size, this study quantified the time and cost used to recruit patients and provides helpful indications of site-level characteristics that can help improve feasibility and efficiency of conducting RCT in GP settings. Characteristics indicative of high levels of support for research and rural practices, which often tends to be overlooked, were observed to be more efficient in recruiting.

Operational Differences between Product Development Partnership, Pharmaceutical Industry, and Investigator Initiated Clinical Trials

“…Offering the chance to explore new sites will provide more insights for timely recruitment and innovations. In resource-constrained settings, in fact, smaller sites and those located in rural settings were found to be more efficient in the recruitment of participants compared to larger sites with competing activities [ 37 ]. It is important to tailor the selection criteria based on disease burden and the real accrual capabilities of the sites.…”

Peer Review Report For: Using publicly available UK datasets to identify recruitment sites to maximise inclusion of under-served groups: three case studies [version 1; peer review: 1 approved]

“…There is evidence that in large multi-centre trials most of the participants come from a small number of high recruiting sites 16,17 . In addition, recruiting at a site serving a diverse population does not necessarily mean that a diverse population will be recruited to the study.…”

Analisis Proses Perekrutan PPPK Daerah di Kantor Badan Kepegawaian Dan Pengembangan Sumber Daya Manusia Kota Gunungsitoli

“…Manajemen ASN tentunya membutuhkan keahlian dan kemampuan khusus dalam bekerja. Oleh karena itu, dapat dikatakan bahwa pekerja professional tentu saja merupakan pekerjaan yang dapat dilaksanakan oleh tenaga khusus yang cakap dan benar-benar siap untuk melaksanakan pekerjaannya, ada kekhususan, keistimewaan dan keutamaan yang mengidentifikasi bahwa PPPK bukan hanya sebagai wadah yang akan diisi secara otomatis oleh para pegawai tidak tetap atau pegawai honorer sebelumnya (Tew et al, 2023 2) yang salah satunya dengan mengumumkan lowongan pelamaran yang jelas melalui media elektronik maupun media cetak, agar informasi tersebut dapat diketahui oleh seluruh masyarakat. Akan tetapi berdasarkan observasi yang dilakukan oleh peneliti, dimana peneliti menemukan masalah yaitu kurangnya informasi yang akurat dan jelas dari BKPSDM kota Gunungsitoli terkait dengan persyaratan perekrutan PPPK di Kota Gunungsitoli sehingga membuat beberapa masyarakat kecewa karena pada dasarnya perekrutan yang dilaksanakan pada saat itu hanya terbuka untuk jabatan fungsional guru.…”

“…Tidak hanya bagi individu yang memiliki akses lebih mudah, tetapi juga untuk mereka yang mungkin berada di wilayah terpencil atau memiliki keterbatasan akses. Hal ini mencerminkan komitmen pemerintah untuk memberikan pelayanan yang setara kepada seluruh warganya (Tew et al, 2023).…”