A strategy for recruiting subjects to test an innovation in community pharmacy

Abstract

Background: Innovations that help the pharmacist identify which patients with lower bowel symptoms should be referred to a doctor may reduce delayed presentation to medical practitioners. This study reports several methods to recruit patients presenting with lower bowel symptoms to a study in community pharmacies. Methods Pharmacies were recruited by contacting the owner of the pharmacy, or the manager, or a pharmacist working in the pharmacy. Eligible patients were invited to complete a validated self-administered questionnaire about their bowel symptoms. The patient was contacted a week later to advise them of a 'risk' score based on the questionnaire. The patient was then contacted four weeks later to ascertain if they had consulted a general practitioner (GP). A recruitment target of 45 patients or six weeks, which ever was achieved first, was set for recruitment to this pilot study. In a separate study, pharmacies were asked to recruit eligible participants to the control arm of the study, in which no intervention other than pharmacist advice was offered. Results: Pharmacies involving the owner exceeded the target recruitment in six weeks; other pharmacies did not achieve the target even after 18 weeks. The age and gender profile of the participants in the two groups were similar. The proportion of patients who merited a referral to their GP was also similar in both groups and ranged from 9% to 10%. No patient chose to participate by completing an internet-based questionnaire. Pharmacies in which a researcher recruited the patients recruited much more slowly than those in which the owner was involved. The recruitment rate to the control arm of the study was also sustained in the pharmacies involving the owners. Conclusions: We estimate that almost half of all eligible patients were recruited when owners were involved. Patients recruited in this study included a significant number who were at risk of chronic and life-limiting illness.