title: Understanding why older people participate in clinical trials: the experience of the Scottish PROSPER participants.
abstract: BACKGROUND
  over the next 20 years it is anticipated that there will be a significant increase in those aged 75 and over, and a consequent increase in cardiovascular disease, cancer and chronic illness. As this shift takes effect, there will be an increased need for treatment strategies that are of known benefit to this age group and a consequent rise in demand for clinical trials that are conducted specifically with the older population. Because factors that motivate older individuals to participate in clinical trials may differ from those that influence younger adults, it is important to evaluate the strategies used to encourage recruitment and retention and to determine how appropriate these are.
  
  
  OBJECTIVE
  evaluation of the reasons why subjects agree to participate in a controlled clinical trial of vascular disease prevention and the strategies used to improve compliance and protocol adherence.
  
  
  METHODS
  Scotland.
  
  
  METHODS
  2,520 Prospective Study of Pravastatin in the Elderly at Risk participants, aged 70-82 with either pre-existing vascular disease or at least one major vascular risk factor (hypertension, cigarette smoking, or diabetes mellitus).
  
  
  METHODS
  two-stage iterative survey. Stage I was exploratory.
  
  
  RESULTS
  curiosity, or an interest in finding out more about the study, 'a desire to support research', and anticipated personal benefits, such as health screening, were the most important motivators for generating initial interest in the trial. Ongoing health monitoring was the most important recruitment and retention motivator (P = 0.001).
  
  
  CONCLUSIONS
  curiosity, self interest and altruism may act as motivators at different points in the study time-line. However, fostering positive relationships between staff and recruits, and keeping recruits informed about the progress of the study are likely to maximise the retention of older subjects to long-term trials.
authors.affiliation: Department of Nursing, Midwifery and Community Health, Glasgow Caledonian University, Glasgow, UK. liz.tolmie@ctunit.co.uk
authors.forename: Elizabeth P
authors.initials: EP
authors.lastname: Tolmie
authors.forename: Moira M B
authors.initials: MM
authors.lastname: Mungall
authors.forename: Greig
authors.initials: G
authors.lastname: Louden
authors.forename: Grace M
authors.initials: GM
authors.lastname: Lindsay
authors.forename: Allan
authors.initials: A
authors.lastname: Gaw
mesh_terms: D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D009042:Motivation; D017035:Pravastatin / Q000627:therapeutic use; D011446:Prospective Studies; D012189:Retrospective Studies; D012606:Scotland
chemical_list: D017035:Pravastatin