Challenges of Recruiting Patients Into Group-Based Stroke Rehabilitation Research: Reflections on Clinician Equipoise Within the Singing for People With Aphasia (SPA) Pilot Trial

摘要

Recruitment into clinical trials is a major challenge (McDonald et al., 2006; Sully et al., 2013;Amstutz et al., 2017; Walters et al., 2017). Recruitment that is too slow can lead to trialsbeing halted and new, promising interventions abandoned (Amstutz et al., 2017). This has theconcomitant effects of wasting participants’ time, research funding, and clinical resource, noneof which sits well ethically. Where clinical populations are the focus of trials (such as a physicalrehabilitation intervention for stroke survivors, or an online CBT programme for anxiety anddepression), multiple sources are often utilized to recruit participants into research (e.g., patientlists, community groups, media-advertisements, disease-specific support programmes). Cliniciansthemselves often adopt a “gatekeeper” role, ultimately deciding whether or not to recommend atrial to their patients. Clinicians can therefore play a fundamental role in the success or failureof recruitment.