Engaging GPs in clinical trials: Barriers and facilitators encountered in the Thyroid Hormone Replacement for Subclinical Hypothyroidism (TRUST) study
Introduction:
The Thyroid Hormone Replacement for Subclinical Hypothyroidism (TRUST) study is an international randomized controlled trial testing the efficacy of thyroxine replacement in subclinical hypothyroidism in older community dwelling adults.
Patients that meet the inclusion criteria are invited to participate via their General Practitioner (GP). To date, 157 general practices in Cork have been contacted by TRUST. However, currently only 77 (49%) practices have agreed to take part in the study. This paper aims to explore the barriers and facilitators to GP recruitment into a clinical trial, as encountered by the TRUST team.
Methods:
Design: Qualitative focus group study. Group discussions were facilitated, audio recorded, and the verbatim transcripts thematically analysed.
Participants: Four clinical and two administrative members of the TRUST clinical trial team.
Results:
Facilitators to GP recruitment included: GP awareness of the study the clinical relevance of the research question; and incentives for GPs such as continuing medical education points (CME points) and a facilitated thyroid audit.
Barriers to recruitment included: lack of access to GPs (i.e. lack of GP registries) professional barriers such as GPs’ concerns for the doctor patient relationship; organisational barriers relating to practice information technology (IT) systems and time commitments; and perceived patient barriers
Conclusion:
This study has implications for the on-going TRUST study and the future of collaborative clinical research in Irish general practice. Researchers should systematically evaluate their recruitment process and adapt it to accommodate the pressures and priorities of GPs, in order to develop successful recruitment strategies in primary care.