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Who does not participate in telehealth trials and why? A cross-sectional survey

BACKGROUND: Telehealth interventions use information and communication technology to provide clinical support. Some randomised controlled trials of telehealth report high patient decline rates. A large study was undertaken to determine which patients decline to participate in telehealth trials and t...

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Autores principales: Foster, Alexis, Horspool, Kimberley A, Edwards, Louisa, Thomas, Clare L, Salisbury, Chris, Montgomery, Alan A, O’Cathain, Alicia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464859/
https://www.ncbi.nlm.nih.gov/pubmed/26044763
http://dx.doi.org/10.1186/s13063-015-0773-3
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author Foster, Alexis
Horspool, Kimberley A
Edwards, Louisa
Thomas, Clare L
Salisbury, Chris
Montgomery, Alan A
O’Cathain, Alicia
author_facet Foster, Alexis
Horspool, Kimberley A
Edwards, Louisa
Thomas, Clare L
Salisbury, Chris
Montgomery, Alan A
O’Cathain, Alicia
author_sort Foster, Alexis
collection PubMed
description BACKGROUND: Telehealth interventions use information and communication technology to provide clinical support. Some randomised controlled trials of telehealth report high patient decline rates. A large study was undertaken to determine which patients decline to participate in telehealth trials and their reasons for doing so. METHODS: Two linked randomised controlled trials were undertaken, one for patients with depression and one for patients with raised cardiovascular disease risk (the Healthlines Study). The trials compared usual care with additional support delivered by the telephone and internet. Patients were recruited via their general practice and could return a form about why they were not participating. RESULTS: Of the patients invited, 82.9 % (20,021/24,152) did not accept the study invite, either by returning a decline form (n = 7134) or by not responding (n = 12,887). In both trials patients registered at deprived general practices were less likely to accept the study invite. Decline forms were received from 29.5 % (7134/24,152) of patients invited. There were four frequently reported types of reasons for declining. The most common was telehealth-related: 54.7 % (3889/,7115) of decliners said they did not have access or the skills to use the internet and/or computers. This was more prevalent amongst older patients and patients registered at deprived general practices. The second was health need-related: 40.1 % (n = 2852) of decliners reported that they did not need additional support for their health condition. The third was related to life circumstances: 27.2 % (n = 1932) of decliners reported being too busy. The fourth was research-related: 15.3 % (n = 1092) of decliners were not interested in the research. CONCLUSIONS: A large proportion of patients declining participation in these telehealth trials did so because they were unable to engage with telehealth or did not perceive a need for it. This has implications for engagement with telehealth in routine practice, as well as for trials, with a need to offer technological support to increase patients’ engagement with telehealth. More generally, triallists should assess why people decline to participate in their studies. TRIAL REGISTRATION: The Healthlines Study has the following trial registrations: depression trial: ISRCTN14172341 (registered 26 June 2012) and CVD risk trial: ISRCTN27508731 (registered 05 July 2012).
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spelling pubmed-44648592015-06-14 Who does not participate in telehealth trials and why? A cross-sectional survey Foster, Alexis Horspool, Kimberley A Edwards, Louisa Thomas, Clare L Salisbury, Chris Montgomery, Alan A O’Cathain, Alicia Trials Research BACKGROUND: Telehealth interventions use information and communication technology to provide clinical support. Some randomised controlled trials of telehealth report high patient decline rates. A large study was undertaken to determine which patients decline to participate in telehealth trials and their reasons for doing so. METHODS: Two linked randomised controlled trials were undertaken, one for patients with depression and one for patients with raised cardiovascular disease risk (the Healthlines Study). The trials compared usual care with additional support delivered by the telephone and internet. Patients were recruited via their general practice and could return a form about why they were not participating. RESULTS: Of the patients invited, 82.9 % (20,021/24,152) did not accept the study invite, either by returning a decline form (n = 7134) or by not responding (n = 12,887). In both trials patients registered at deprived general practices were less likely to accept the study invite. Decline forms were received from 29.5 % (7134/24,152) of patients invited. There were four frequently reported types of reasons for declining. The most common was telehealth-related: 54.7 % (3889/,7115) of decliners said they did not have access or the skills to use the internet and/or computers. This was more prevalent amongst older patients and patients registered at deprived general practices. The second was health need-related: 40.1 % (n = 2852) of decliners reported that they did not need additional support for their health condition. The third was related to life circumstances: 27.2 % (n = 1932) of decliners reported being too busy. The fourth was research-related: 15.3 % (n = 1092) of decliners were not interested in the research. CONCLUSIONS: A large proportion of patients declining participation in these telehealth trials did so because they were unable to engage with telehealth or did not perceive a need for it. This has implications for engagement with telehealth in routine practice, as well as for trials, with a need to offer technological support to increase patients’ engagement with telehealth. More generally, triallists should assess why people decline to participate in their studies. TRIAL REGISTRATION: The Healthlines Study has the following trial registrations: depression trial: ISRCTN14172341 (registered 26 June 2012) and CVD risk trial: ISRCTN27508731 (registered 05 July 2012). BioMed Central 2015-06-05 /pmc/articles/PMC4464859/ /pubmed/26044763 http://dx.doi.org/10.1186/s13063-015-0773-3 Text en © Foster et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Foster, Alexis
Horspool, Kimberley A
Edwards, Louisa
Thomas, Clare L
Salisbury, Chris
Montgomery, Alan A
O’Cathain, Alicia
Who does not participate in telehealth trials and why? A cross-sectional survey
title Who does not participate in telehealth trials and why? A cross-sectional survey
title_full Who does not participate in telehealth trials and why? A cross-sectional survey
title_fullStr Who does not participate in telehealth trials and why? A cross-sectional survey
title_full_unstemmed Who does not participate in telehealth trials and why? A cross-sectional survey
title_short Who does not participate in telehealth trials and why? A cross-sectional survey
title_sort who does not participate in telehealth trials and why? a cross-sectional survey
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464859/
https://www.ncbi.nlm.nih.gov/pubmed/26044763
http://dx.doi.org/10.1186/s13063-015-0773-3
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