title: Recruiting to inpatient-based rehabilitation trials: lessons learned.
abstract: Effective recruitment is central to successful trials but is often problematic. This article reports the lessons learnt while recruiting stroke rehabilitation patients to a multi-centre randomised control trial. As intended, 94 participants were recruited from 12 inpatient stroke rehabilitation services in Northwest England over 12 months; however, recruitment rates were highly varied (from 0.6 to 2.5 participants per site per month) as were the nature of the stroke services and the personnel available. Consequently, bespoke recruitment procedures were needed at each site. As the assessment skills needed to screen for the selection criteria were specific to therapists, our most common strategy was for the hospital therapists to screen patients and make referrals directly to the trial team. However, we identified several strategies undertaken by the research nurse in the highest recruiting site that appeared to positively impact on recruitment. These strategies included involving the whole multidisciplinary team, being part of the stroke team, facilitating contact between the clinical and trial teams and using inclusive recruitment and watchful waiting strategies. Rehabilitation trials frequently require skilled assessments by therapists, rather than by doctors or nurses to identify potential participants. Thus, research support models need to include suitably skilled trial therapists. Recruitment can be enhanced by enthusiastic, regular and structured engagement with the entire stroke multidisciplinary team and by using inclusive recruitment and 'watchful waiting' strategies to identify and monitor potential participants.
  
  
  BACKGROUND
  ISRCTN29533052 . Registered May 2011.
authors.affiliation: School of Nursing Midwifery & Social Work, University of Manchester, Manchester, UK. Sarah.tyson@manchester.ac.uk.|Stroke Research Centre, University of Manchester, Manchester, UK. Sarah.tyson@manchester.ac.uk.|Jean McFarlane Building University of Manchester, Oxford Rd, Manchester, M13 9PL, UK. Sarah.tyson@manchester.ac.uk.
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Tyson
authors.affiliation: School of Nursing Midwifery & Social Work, University of Manchester, Manchester, UK. Nessa.tomas@manchester.ac.uk.|Stroke Research Centre, University of Manchester, Manchester, UK. Nessa.tomas@manchester.ac.uk.|Jean McFarlane Building University of Manchester, Oxford Rd, Manchester, M13 9PL, UK. Nessa.tomas@manchester.ac.uk.
authors.forename: Nessa
authors.initials: N
authors.lastname: Thomas
authors.affiliation: Stroke Research Centre, University of Manchester, Manchester, UK. Andy.vail@manchester.ac.uk.|Centre for Biostatistics, University of Manchester, Manchester, UK. Andy.vail@manchester.ac.uk.|Jean McFarlane Building University of Manchester, Oxford Rd, Manchester, M13 9PL, UK. Andy.vail@manchester.ac.uk.
authors.forename: Andy
authors.initials: A
authors.lastname: Vail
authors.affiliation: Stroke Research Centre, University of Manchester, Manchester, UK. Pippa.tyrrell@manchester.ac.uk.|Salford Royal Foundation NHS Trust, Stott Lane, Salford, M6 8D, UK. Pippa.tyrrell@manchester.ac.uk.|Manchester Academics Health Sciences Centre, Manchester, UK. Pippa.tyrrell@manchester.ac.uk.
authors.forename: Pippa
authors.initials: P
authors.lastname: Tyrrell
mesh_terms: D006801:Humans; D007297:Inpatients; D018579:Patient Selection; D000071939:Stroke Rehabilitation