부산대학교 도서관

Recruitment to randomised controlled trials (RCTs) is often challenging, with many RCTs failing to recruit to time and target. Studies exploring recruitment are widespread, but few focus on how patients interpret and use information conveyed by recruiters. The aim of this PhD was to improve understanding of recruitment to RCTs from the perspective of both recruiters and patients, with a focus on how information is communicated by recruiters and understood by patients. This was addressed by undertaking: 1) a qualitative evidence synthesis (QES) of the current literature on recruiters' perspectives and experiences of RCT recruitment, and 2) primary qualitative research across three 'case-study' RCTs, comprising audio-recording recruitment encounters between recruiters and potential trial participants ('patients'), and interviews with patients to explore interpretations of information communicated by recruiters. Data were analysed thematically, using constant comparison approaches. Where possible, consultation audio-recordings and interviews were linked for analysis. Overall, key findings highlighted how patients drew heavily on information conveyed by both recruiting and non-recruiting health care professionals (HCPs) about treatments they would benefit from or 'needed', which in turn shaped their interpretations of uncertainty around treatment effectiveness. Although patients referred to other sources of information (e.g., study documentation) and the views of family and friends, these were used to confirm information conveyed by HCPs and solidify trial participation decisions. The findings from this PhD have revealed the direct ways in which the information conveyed by HCPs shapes patients' perceptions of treatment benefit and need, and thus views about RCT participation. The findings highlight opportunities for future recruitment interventions to support both recruiters and non-recruiting HCPs throughout the clinical pathway in their communication of uncertainty, in light of the central role these encounters play in shaping patients perceptions of treatments they 'need' or stand to benefit from as an individual.