Barriers | Strategies to help overcome |
---|---|
Recruitment and participation | |
Prescriber disagreement about recruitment across sites: clinical eligibility compared to trial suitability | • Prior to implementation, identify potential sources for disagreement, provide examples and workshop solutions with providers |
• Throughout recruitment, facilitate a forum for providers to discuss with research team actual difficulties encountered | |
Potential negative impact of evaluated intervention on provider’s business revenue | • Identify and discuss potential impacts (immediate and long-term) with providers; |
• If possible, ensure lost revenue adequately compensated | |
• Educate potential providers about the value of the intervention to public good | |
Highly mobile patients | • Consider provision of mobile recruitment services |
Research and primary practice settings | |
Inadequate research infrastructure | • Ensure adequate physical space available for trial processes |
• Understand information technology (IT) capacity at sites and use study systems that can integrate with pre-existing IT, thus minimising training requirements | |
• Consider using data extraction tools to minimise access time to information technology systems | |
• Ensure adequate remuneration to participants for time and service provided | |
• Consider provision of dedicated research coordinator at sites, particularly those already understaffed | |
Pre-existing workforce strains | • Adequately understand workforce-related issues at participating sites |
• Ensure adequate personnel support is available and can respond to high staff turnover | |
• Ensure adequate training at practice level, and refresher training available and budgeted for | |
Potential miscommunication across multidisciplinary health services beyond primary care | • Provision of simple communication tools at the patient and practice levels that highlight patient involvement within the trial. |
• Adequately educating patients and carers regarding about trial and need for communicating to all healthcare providers | |
• Identify participant multidisciplinary providers at enrolment and target trial communication strategies accordingly | |
Increased administrative burden relative to health service delivery and patient care demands | • Provide adequate research support to sites that can minimise administrative burden |
• Consider automated procedures that ensure Good Clinical Practice compliance and can integrate with current health service processes | |
• Ensure site service delivery requirements are fully understood prior to implementatin | |
• Provide clear education about Good Clinical Practice | |
• Practice requirements and administrative needs prior to recruitment | |
Costs | |
High trial running costs | • Ensure adequate budget for provision of research support personnel at sites to maintain recruitment timelines, ease administrative burden to sites and reduce opportunity cost to sites |
• Additional funding load to accommodate inadequate primary care research infrastructure | |
• In medium to long term establish a funding pool to invest in primary healthcare research infrastructure | |
Opportunity cost to participants | • Understand potential costs to participants prior to implementation |
• Provide adequate remuneration to participants in light of actual time required for administration, including time spent with research nurses | |
• Ensure simple processes for sites to apply for and receive remuneration |