Experience of retaining patients in a randomised control trial translated into clinical practice

Title: Experience of retaining patients in a randomised control trial translated into clinical practice
Author(s): L. Lombard, E. MacHale, V. Brennan, J. Walsh, S. Plunkett, C. Mulvey, G. Greene, T. McCarten, M. Mokoka, RW. Costello
Institution: Ropyal College of Surgeons Ireland
Poster: Click to view poster
Category: Asthma and COPD
Abstract: There is a higher non-attendance rate seen in patients with uncontrolled asthma compared to other respiratory conditions (32.6% versus 23.7%) 1. Continuity of care in this cohort is essential. Similarly in medical research, high attrition may threaten the validity of study findings. Retention strategies should be addressed during the study design phase as attrition rates for asthma RCTs can be up to 40%2. These strategies can translate into clinical practice.

We report the attrition rates from an eight month, prospective RCT (INCASUN). Patients were randomized into two groups; group one personalized biofeedback, group two standard care. Patients attended the research facility monthly. Various retention strategies were implemented in this study such as; building rapport with the study team, no waiting times, telephone reminders and paid parking.

Four sites had an attrition rate of 0%. 20 patients withdrew from the six remaining, with an overall attrition rate of 9%. Between site difference was observed, suggesting strategies implemented reduce attrition rates. The lowest attrition rate was seen in the biofeedback group (25%) demonstrating that patient engagement in their own care is an important factor.

Lessons learnt can be translated into clinical practice. The NHS estimates an economic cost of £600m/year due to non-attendance at clinics. Implementing these strategies would be cost effective and improve patient outcomes.