Issues with recruitment to randomised controlled trials in the drug and alcohol field: a literature review and Australian case study.
OBJECTIVE
The randomised control trial (RCT) is a widely used tool for measuring the effectiveness of health treatments and services. However, subject recruitment is an ongoing challenge for those conducting RCTs and may have a serious impact on the success of the study and the reliability of the outcomes.


METHODS
In this review we present an examination of the problems and strategies associated with recruitment to RCTs, with particular reference to studies conducted in the drug and alcohol field. A case study of recruitment to an RCT for the treatment of alcohol dependence is presented, supplemented by PubMed, Current Contents and Medline searches to identify relevant publications.


RESULTS
The literature suggests that the most common barriers to patient participation involve fears of assignment to placebo treatment, insufficient compensation and poor attendance at initial appointments. Moreover, subject referrals from staff may be a greater problem than reluctance of patients. Referrals are inhibited by complicated entry criteria, time constraints due to busy work schedules or a limited research culture.


CONCLUSIONS
Subject recruitment may be promoted by financial reimbursement, close partnerships between research and referral staff; increasing the treatment group ratio in multi-drug trials to minimise randomisation to placebo; addressing negative staff attitudes; and simplifying the referral process.


CONCLUSIONS
The need for multi-centre sites in Australian drug and alcohol treatment studies is highlighted.
Thomson
Clare L
CL
Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Morley
Kirsten C
KC
Teesson
Maree
M
Sannibale
Claudia
C
Haber
Paul S
PS
D001291:Attitude of Health Personnel; D001315:Australia; D004358:Drug Therapy; D006801:Humans; D018579:Patient Selection; D011369:Professional-Patient Relations; D016032:Randomized Controlled Trials as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000628:therapy*