Evaluation of strategies to recruit and retain older people with dementia and their informal carers into a Tai Chi Trial to improve balance and prevent falls

M. Heward, Layla Johnson, S. Nyman
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Abstract

Abstract Objectives: Randomised control trials (trials) involving people with dementia lack detailed analysis of recruitment and retention strategies. To address this, we examined the effectiveness of strategies in “The TACIT Trial: TAi ChI for people with demenTia” Methods: We recruited dyads (people with dementia and carers) from 3 South of England sites utilising different strategies. Recruitment strategy effectiveness was measured by percent yield (number randomised of total referrals) and cost per randomised participant. Our retention strategy (maintaining contact with participants during weekly telephone calls) was measured by percent yield (number retained by six-month follow-up). Results: Of 359 dyads, 24% were randomised into the study (n=85). The most resource-intensive strategy (research nurses spending 30 minutes explaining the study) had the highest referral to randomisation rate. An incremental cost-effectiveness ratio suggested an alternative approach (nurses and doctors spending 5 minutes explaining the study) was most cost-effective. Retention rates were 86% (n=36/42; intervention group) and 81% (35/43; control group); main reasons for attrition were worsening health and lack of study interest. Conclusions: The results demonstrate person-centred strategies enabling staff to spend time with participants were effective in supporting recruitment and retention. Those designing future trials must consider such strategies and the associated costs.
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评估招募和留住老年痴呆症患者及其非正式护理人员参加太极拳试验以改善平衡和预防跌倒的策略
目的:涉及痴呆患者的随机对照试验(试验)缺乏对招募和保留策略的详细分析。为了解决这个问题,我们在“默会试验:太极拳对痴呆症患者”中检查了策略的有效性。方法:我们从英格兰南部的3个地点招募了使用不同策略的二人组(痴呆症患者和护理人员)。招募策略的有效性通过百分比收益(总推荐的随机数量)和每个随机参与者的成本来衡量。我们的留存策略(在每周的电话中与参与者保持联系)是用百分比收益率(六个月的随访中保留的人数)来衡量的。结果:359对中,24%被随机纳入研究(n=85)。资源最密集的策略(研究护士花30分钟解释研究)有最高的随机转诊率。增量成本-效果比表明另一种方法(护士和医生花5分钟解释研究)是最具成本效益的。保留率为86% (n=36/42;干预组)和81% (35/43;对照组);流失的主要原因是健康状况恶化和缺乏学习兴趣。结论:结果表明,以人为本的策略使工作人员能够花时间与参与者在支持招聘和保留有效。那些设计未来试验的人必须考虑这些策略和相关成本。
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