title: Strategies to support recruitment of patients with life-limiting illness for research: the Palliative Care Research Cooperative Group.
abstract: BACKGROUND
  The Palliative Care Research Cooperative Group (PCRC) is the first clinical trials cooperative for palliative care in the U.S.
  
  
  OBJECTIVE
  To describe barriers and strategies for recruitment during the inaugural PCRC clinical trial.
  
  
  METHODS
  The parent study was a multisite randomized controlled trial enrolling adults with life expectancy anticipated to be one to six months, randomized to discontinue statins (intervention) vs. to continue on statins (control). To study recruitment best practices, we conducted semistructured interviews with 18 site principal investigators (PIs) and clinical research coordinators (CRCs) and reviewed recruitment rates. Interviews covered three topics: 1) successful strategies for recruitment, 2) barriers to recruitment, and 3) optimal roles of the PI and CRC.
  
  
  RESULTS
  All eligible site PIs and CRCs completed interviews and provided data on statin protocol recruitment. The parent study completed recruitment of 381 patients. Site enrollment ranged from 1 to 109 participants, with an average of 25 enrolled per site. Five major barriers included difficulty locating eligible patients, severity of illness, family and provider protectiveness, seeking patients in multiple settings, and lack of resources for recruitment activities. Five effective recruitment strategies included systematic screening of patient lists, thoughtful messaging to make research relevant, flexible protocols to accommodate patients' needs, support from clinical champions, and the additional resources of a trials cooperative group.
  
  
  CONCLUSIONS
  The recruitment experience from the multisite PCRC yields new insights into methods for effective recruitment to palliative care clinical trials. These results will inform training materials for the PCRC and may assist other investigators in the field.
authors.affiliation: Division of Geriatric Medicine and Palliative Care Program, University of North Carolina, Chapel Hill, North Carolina, USA; Cecil B. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina, USA. Electronic address: lhanson@med.unc.edu.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Hanson
authors.affiliation: Four Seasons Hospice and Palliative Care, Flat Rock, North Carolina, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Bull
authors.affiliation: Cecil B. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Wessell
authors.affiliation: Four Seasons Hospice and Palliative Care, Flat Rock, North Carolina, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Massie
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Denver, Colorado, USA.
authors.forename: Rachael E
authors.initials: RE
authors.lastname: Bennett
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Denver, Colorado, USA.
authors.forename: Jean S
authors.initials: JS
authors.lastname: Kutner
authors.affiliation: National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Noreen M
authors.initials: NM
authors.lastname: Aziz
authors.affiliation: Division of Oncology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Abernethy
mesh_terms: D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007407:Interviews as Topic; D015337:Multicenter Studies as Topic; D010166:Palliative Care / Q000379:methods; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Palliative care; clinical trials; recruitment; research networks