Retention rate good for difficult population
Here's how to improve retention
One of the key strategies to retaining clinical trial enrollment, particularly when the participants are from vulnerable populations, is exhibiting respect and a nonjudgmental attitude during all encounters, an expert says.
"You need to assess your personal beliefs and get a handle on those, understanding how you feel about their choices," says Pamela Normandin, RN, MSN, CCRC, a clinical nurse specialist in the office of research at Iowa Lutheran Hospital in Des Moines, IA.
Normandin has been involved in clinical trials that enrolled methamphetamine addicts, a population that often has legal problems and other socioeconomic issues. The site's retention rate is around 70 percent, she says.
"I've not had a history of addiction myself," Normandin says. "But I think you need to look at your own beliefs and just need to try to be happy to see them every time they arrive, even if they're late, which most of the time they are."
Here are some other strategies for retention:
• Make numerous follow-up calls: "If they don't show, we'll call," Normandin says.
When calling the CT associate will be careful to leave a message that doesn't reveal exactly who and why the call was made, she notes.
"Don't leave phone numbers," Normandin says. "We're careful and say, 'Hi, this is Pam at Lutheran. We miss you and want to know that you're doing okay.'"
The clinical research involving meth addiction required participants to commit to five months in the trial, with multiple visits per week, and so about 90 %of them missed at least one scheduled meeting, Normandin says.
The CT staff did not call participants to remind them of scheduled appointments, but they would write the dates and times on business cards when asked, she adds.
• Provide small amenities: "We have sweets, snacks, peanuts, cashews, trail mixes, candy, and soda pop and a water bottle," Normandin says. "Some of them do not eat very well, so we try to have food available that will give them sustenance."
Also, the CT site gives participants vouchers at each visit, including a $10 voucher that could be used at a convenience store for gas or cigarettes, she says.
"About 80-90 %of them smoke cigarettes, which are very expensive in our state," Normandin says. "So if they come in three times a week, they'll receive $30 in vouchers."
The CT site also will offer emergency transportation: "If someone can't get here, and it's a critical appointment, we'll send a taxi for them and use a taxi voucher," Normandin says.
• Track down the no-shows: The CT site has one effective strategy for finding people who have moved from their known address and whose numbers are no longer in service. CT staff will call the participant's friends or family.
"We have people fill out a locator form that supplies us with the names and contact information about two people who the [participant] feels comfortable giving us," Normandin says.
"Like one girl gave me her mom and grandma's information," she adds. "So I might be able to reach the grandma, who might say, 'I'm sorry to say she's in prison.'"
Normandin will then document that the participant is in prison and close out her participation since the trial does not enroll anyone who is in prison during the trial.
When calling the family or friends, Normandin will be careful in how she identifies herself and asks questions.
"I say, 'I'm Pam from Lutheran, and I'm looking for this person for an appointment,' and I don't elaborate on what I need unless the person has signed a release for me to give information to her mother," Normandin explains.
One of the key strategies to retaining clinical trial enrollment, particularly when the participants are from vulnerable populations, is exhibiting respect and a nonjudgmental attitude during all encounters, an expert says.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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