Background/Purpose
In a large-scale clinical trial with a long-term outcome, it is essential to use recruitment strategies that are both cost-effective and likely to yield eligible participants. The objective of this study is to evaluate the different recruitment methods utilized to date in the Tai Chi and Aerobic Exercise for Fibromyalgia study in terms of a.) yield (% prescreened, % screened, and % randomized) and b.) cost-effectiveness.
Methods
All participants were recruited within a 20-month time period between January 2012 and September 2013. Recruitment strategies included 1.) clinical referrals; 2.) word of mouth; 3.) ads posted in electronic sources (Craigslist, Google, NIH website, clinicalconnection.com, clinicaltrials.gov, and Tufts website); 4.) ads placed in a local newspaper, the Boston Metro; 5.) flyers posted in the hospital and in the surrounding neighborhood; and 6.) direct mailings to patients. Recruitment costs were calculated by summing advertising, printing, and personnel costs. Percentages were calculated for prescreened, screened, randomized into an intervention arm, and yield (#randomized/#participants contacted). We compared the strategies in terms of yield and cost-effectiveness.
Results
492 participants were prescreened, 195 were screened at baseline (40% of prescreened) and 165 (85% of screened) were randomized. Ads placed in the Boston Metro yielded the most randomized participants (76) and second highest percentage of randomized participants per prescreen (38.38%) but also had highest associated costs ($273.65/participant). Mailings to patients produced the second highest number of randomized participants (27) and the highest percentage of randomized participants/prescreen (38.57%) and had much lower associated costs ($23.44/participant). Flyers posted within the hospital and in the surrounding neighborhood generated 32.69% of randomized participants/prescreen, 17 participants, and had associated costs of $17.50/participant. Clinical referrals produced 18 randomized participants (29.03% randomized/prescreen) and had no associated costs. Other referrals generated 2 randomized participants and 12.50% of those prescreened. Electronic ads produced 15 randomized participants, 32.61% of those prescreened by this method, and had no associated costs.
|
Table 1. Yield and cost of clinical referrals, word of mouth, electronic advertising, advertising in local newspaper, flyers posted in hospital, and direct mailings to patients. |
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|
Clinical referral |
Word of Mouth |
Electronic ad |
Newspaper/magazine |
Flyer |
Direct mailing |
|
|
Participants prescreened |
62 |
16 |
46 |
198 |
52 |
70 |
|
Screened |
24 |
2 |
18 |
90 |
21 |
30 |
|
Randomized |
18 |
2 |
15 |
76 |
17 |
27 |
|
Yield |
29.03% |
12.50% |
32.61% |
38.38% |
32.69% |
38.57% |
|
Cost per enrolled |
$0 |
$0 |
$0 |
$273.65 |
$17.50 |
$23.44 |
|
Total Costs |
$0 |
$0 |
$0 |
$20800a |
$297.45b |
$632.90c |
|
aAdvertising bPrinting, personnel cPrinting, personnel, postage |
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Conclusion
Ads placed in the Metro were significantly more costly than any of the other strategies, but yielded 46.06% of participants randomized in the study. Clinical referrals, word of mouth, and electronic ads were the most cost-effective strategies; however, they yielded the fewest randomized participants. In future studies conducted with this population in this location, a strong recruitment strategy would include placing Metro ads and expanding the patient mailing list and number of referring physicians through the mechanism of educating more physicians about the study.
Disclosure:
A. Schmid,
None;
W. F. Harvey,
None;
L. L. Price,
None;
C. Wang,
None.
« Back to 2014 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/cost-effectiveness-and-yield-of-different-recruitment-strategies-utilized-in-an-exercise-trial-of-fibromyalgia-patients/