Jordan M Harrison1, Miyeon Jung2, Terry A Lennie3, Debra K Moser3, Dean G Smith4, Sandra B Dunbar5, David L Ronis1, Todd M Koelling6, Bruno Giordani7, Penny L Riley1, Susan J Pressler8. 1. School of Nursing, University of Michigan, Ann Arbor, MI, USA. 2. School of Nursing, Indiana University, Indianapolis, IN, USA. 3. College of Nursing, University of Kentucky, Lexington, KY, USA. 4. Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA. 5. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA. 6. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. 7. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. 8. Center for Enhancing Quality of Life in Chronic Illness, School of Nursing, Indiana University, Indianapolis, IN, USA.
Abstract
AIMS AND OBJECTIVES: The objective of this retrospective study was to evaluate reasons heart failure patients decline study participation, to inform interventions to improve enrollment. BACKGROUND: Failure to enrol older heart failure patients (age > 65) and women in studies may lead to sampling bias, threatening study validity. DESIGN: This study was a retrospective analysis of refusal data from four heart failure studies that enrolled 788 patients in four states. METHODS: Chi-Square and a pooled t-test were computed to analyse refusal data (n = 300) obtained from heart failure patients who were invited to participate in one of the four studies but declined. RESULTS: Refusal reasons from 300 patients (66% men, mean age 65·33) included: not interested (n = 163), too busy (n = 64), travel burden (n = 50), too sick (n = 38), family problems (n = 14), too much commitment (n = 13) and privacy concerns (n = 4). Chi-Square analyses showed no differences in frequency of reasons (p > 0·05) between men and women. Patients who refused were older, on average, than study participants. CONCLUSIONS: Some reasons were patient-dependent; others were study-dependent. With 'not interested' as the most common reason, cited by over 50% of patients who declined, recruitment measures should be targeted at stimulating patients' interest. Additional efforts may be needed to recruit older participants. However, reasons for refusal were consistent regardless of gender. RELEVANCE TO CLINICAL PRACTICE: Heart failure researchers should proactively approach a greater proportion of women and patients over age 65. With no gender differences in type of reasons for refusal, similar recruitment strategies can be used for men and women. However, enrolment of a representative proportion of women in heart failure studies has proven elusive and may require significant effort from researchers. Employing strategies to stimulate interest in studies is essential for recruiting heart failure patients, who overwhelmingly cited lack of interest as the top reason for refusal.
AIMS AND OBJECTIVES: The objective of this retrospective study was to evaluate reasons heart failurepatients decline study participation, to inform interventions to improve enrollment. BACKGROUND: Failure to enrol older heart failurepatients (age > 65) and women in studies may lead to sampling bias, threatening study validity. DESIGN: This study was a retrospective analysis of refusal data from four heart failure studies that enrolled 788 patients in four states. METHODS: Chi-Square and a pooled t-test were computed to analyse refusal data (n = 300) obtained from heart failurepatients who were invited to participate in one of the four studies but declined. RESULTS: Refusal reasons from 300 patients (66% men, mean age 65·33) included: not interested (n = 163), too busy (n = 64), travel burden (n = 50), too sick (n = 38), family problems (n = 14), too much commitment (n = 13) and privacy concerns (n = 4). Chi-Square analyses showed no differences in frequency of reasons (p > 0·05) between men and women. Patients who refused were older, on average, than study participants. CONCLUSIONS: Some reasons were patient-dependent; others were study-dependent. With 'not interested' as the most common reason, cited by over 50% of patients who declined, recruitment measures should be targeted at stimulating patients' interest. Additional efforts may be needed to recruit older participants. However, reasons for refusal were consistent regardless of gender. RELEVANCE TO CLINICAL PRACTICE: Heart failure researchers should proactively approach a greater proportion of women and patients over age 65. With no gender differences in type of reasons for refusal, similar recruitment strategies can be used for men and women. However, enrolment of a representative proportion of women in heart failure studies has proven elusive and may require significant effort from researchers. Employing strategies to stimulate interest in studies is essential for recruiting heart failurepatients, who overwhelmingly cited lack of interest as the top reason for refusal.
Authors: Alan S Go; Dariush Mozaffarian; Véronique L Roger; Emelia J Benjamin; Jarett D Berry; Michael J Blaha; Shifan Dai; Earl S Ford; Caroline S Fox; Sheila Franco; Heather J Fullerton; Cathleen Gillespie; Susan M Hailpern; John A Heit; Virginia J Howard; Mark D Huffman; Suzanne E Judd; Brett M Kissela; Steven J Kittner; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; Rachel H Mackey; David J Magid; Gregory M Marcus; Ariane Marelli; David B Matchar; Darren K McGuire; Emile R Mohler; Claudia S Moy; Michael E Mussolino; Robert W Neumar; Graham Nichol; Dilip K Pandey; Nina P Paynter; Matthew J Reeves; Paul D Sorlie; Joel Stein; Amytis Towfighi; Tanya N Turan; Salim S Virani; Nathan D Wong; Daniel Woo; Melanie B Turner Journal: Circulation Date: 2013-12-18 Impact factor: 29.690
Authors: Linda K Parreco; Rhonda W DeJoice; Holly A Massett; Rose Mary Padberg; Sona S Thakkar Journal: J Oncol Pract Date: 2012-03-27 Impact factor: 3.840
Authors: Nancy D Berkman; Stacey L Sheridan; Katrina E Donahue; David J Halpern; Anthony Viera; Karen Crotty; Audrey Holland; Michelle Brasure; Kathleen N Lohr; Elizabeth Harden; Elizabeth Tant; Ina Wallace; Meera Viswanathan Journal: Evid Rep Technol Assess (Full Rep) Date: 2011-03
Authors: Theresa M Beckie; Mary Ann Mendonca; Gerald F Fletcher; Douglas D Schocken; Mary E Evans; Steven M Banks Journal: J Cardiopulm Rehabil Prev Date: 2009 Jan-Feb Impact factor: 2.081
Authors: Arianna Poli; Susanne Kelfve; Leonie Klompstra; Anna Strömberg; Tiny Jaarsma; Andreas Motel-Klingebiel Journal: J Med Internet Res Date: 2020-06-05 Impact factor: 5.428