Recruiting patients to research? Our top tips on working that waiting room…

Recruiting patients can be difficult at the best of times, but how about when you only have a few minutes to explain the study, in a GP’s surgery waiting room, and you are asking for the person’s consultation with the doctor to be video recorded? Well, in short, it’s tricky. So, we thought we would share our experiences working on the Improve project, which (amongst other things) is aiming to video record around 500 consultations between GPs and patients so as to compare patients’, GPs’ and external evaluators’ assessments of communication within the consultation.

Normally, ethics committees require researchers allow at least a 24 hour period for potential participants to consider their decision about involvement. Sadly, we don’t have that luxury. We want to keep the process of patients visiting the GP as normal as possible, so we capture what it is really like. Given that most people book on the day to see the doctor, writing to them in advance would make for a very biased sample. So, what can you do? Well, the receptionists play a very important role, so it’s vital to get them on board with the study. We ask them to request that patients arrive ten minutes before their appointment because the doctor is taking part in some research. Of course, few patients actually do this, so in reality, we still only have five minutes or so before they are called in to see the doctor. When they arrive, the receptionist helpfully (we hope) points the patient in our direction, at which point we explain as clearly and concisely as possible about the study, making sure to mention key points, such as what they have to do, confidentiality, and right to withdraw. Helpfully, the ethics committee granted us permission to use a ‘summary information sheet’ in addition to the full spiel, so this helps to get the main points across clearly.

I have mentioned the right to withdraw. In this study, we are asking patients to complete an exit survey so as they leave the consultation, there we are, ready to grab them. This next part is really key in the consent process: we ask patients to re-consent after they have seen the doctor, to give them the opportunity to change their minds and withdraw immediately after their consultation. Video recording such a personal and sensitive discussion can be daunting (both for the patient and the doctor) and it is really important that the patient understands what they are agreeing to. Of course, they can still withdraw at any point after leaving the surgery too. So, bearing all of this in mind, what sort of consent rates are we getting? Well, surprisingly high at around 75% in fact – this is in line with other published researched (Coleman, 2000). Around 260 consultations successfully filmed so far, only another 250+ to go.

 

Approved by Hertfordshire Research Ethics Committee REC ref: 11/EE/0353

 

Coleman, T. (2000). Using video-recorded consultations for research in primary care: advantages and limitations. Family Practice, 17, 422-427.

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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.