探索招募老年人参与随机试验的挑战,评估在英国全科诊所治疗白大衣高血压的可行性:混合方法研究。

IF 1.5 Q3 PERIPHERAL VASCULAR DISEASE Current Hypertension Reviews Pub Date : 2024-08-19 DOI:10.2174/0115734021299574240809114921
Ekow Mensah, Khalid Ali, Michael Okorie, Stephen Bremner, Colin McAlister, Nicky Perry, Chakravarthi Rajkumar
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引用次数: 0

摘要

简介:白大衣高血压(WCH)与老年人心血管疾病的不良后果之间存在公认的联系。然而,目前对这一群体的白大衣高血压管理尚未达成共识。高龄老人高血压试验(HYVET-2)研究的目的是评估将英国普通诊所的 100 名 75 岁以上白大衣高血压患者随机分配到治疗或常规护理的可行性。该研究没有对任何患者进行随机治疗。在这项后续研究中,我们试图探索未招募患者的原因:此外,我们还采用了混合方法研究设计,向英国肯特郡、萨里郡和萨塞克斯郡(KSS)的29个全科诊所(GP)和临床研究网络(CRN)的工作人员发送了一份在线问卷,内容涉及当地的研究设施和基础设施、HYVET-2研究方法和目标人群的人口统计数据:共有 19 人(15 名初级保健人员和 4 名 CRN 人员)回复了在线问卷。此外,通过框架方法,我们确定了六个主题,概括了 HYVET-2 招募工作面临的挑战。这些主题包括:基层医疗机构管理老年人妇女儿童疾病的既定方法、目标患者的人口统计学特征、研究设计的复杂性、面向患者的研究文件、基层医疗机构有限的研究资源以及使用现有编码识别符合条件的患者:我们的经验表明,从基层医疗机构招募老年人参与 WCH 研究是不可行的。在英国的初级保健医生中开展全国范围的调查,以及针对患有WCH的老年人开展强有力的患者和公众参与(PPI),可能会改善未来针对老年人WCH管理的研究的招募情况。
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Exploring the Challenges of Recruiting Older People for a Randomised Trial Assessing the Feasibility of Treating White Coat Hypertension in the UK General Practices: A Mixed-methods study.

Introduction: There is a recognised association between white coat hypertension (WCH) and adverse cardiovascular outcomes in older adults. However, there is no consensus on the management of WCH in this group. The objective of the Hypertension in the Very Elderly Trial (HYVET-2) study was to assess the feasibility of randomising 100 patients > 75years with WCH from General Practice in the UK to treatment or usual care. The study did not randomise any patients. In this follow-up study, we sought to explore the reasons for not recruiting.

Methods: Furthermore, using a mixed-methods study design, staff from 29 General Practice (GP) sites and the Clinical Research Network (CRN) in Kent, Surrey, and Sussex (KSS), UK, were sent an online questionnaire about local research facilities and infrastructure, and HYVET-2 study methodology and target population demographics.

Results: Nineteen (19) individuals responded to the online questionnaires (15 primary care staff, 4 CRN staff). Moreover, using a framework approach, we identified six themes summarising challenges to HYVET-2 recruitment. These themes are established approaches of primary care towards managing WCH in older people, target patient demographics, study design complexity, patient- facing study documents, limited research resources in primary care, and identification of eligible patients using existing coding.

Conclusion: Our experience showed that recruiting older people from primary care to a WCH study was not feasible. A national scoping survey amongst primary care physicians in the UK, as well as robust patient and public involvement (PPI) targeting older people with WCH, might improve recruitment in future studies addressing the management of WCH in older people.

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来源期刊
Current Hypertension Reviews
Current Hypertension Reviews PERIPHERAL VASCULAR DISEASE-
CiteScore
4.80
自引率
0.00%
发文量
26
期刊介绍: Current Hypertension Reviews publishes frontier reviews/ mini-reviews, original research articles and guest edited thematic issues on all the latest advances on hypertension and its related areas e.g. nephrology, clinical care, and therapy. The journal’s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all clinicians and researchers in the field of hypertension.
期刊最新文献
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