Context The Palliative Care Research Cooperative group (PCRC) is the first clinical trials cooperative for palliative care in the United States. on statin protocol recruitment. The parent study completed recruitment of n=381 patients. Site enrollment ranged from 1-109 participants with an average of Mouse monoclonal to Neuropilin and tolloid-like protein 1 25 enrolled per site. Five major barriers included difficulty locating eligible patients severity of illness family and provider protectiveness seeking patients in multiple settings and lack of resources for recruitment activities. Five effective recruitment strategies included systematic screening of patient lists thoughtful messaging to make research relevant flexible protocols to accommodate patients’ needs support from clinical champions and the additional resources of a trials cooperative group. Conclusion The recruitment experience from the multi-site PCRC yields new insights into methods for effective recruitment to palliative care clinical trials. These results will inform training materials for the PCRC and may assist other investigators in the field. Information on disease stage functional status or anticipated life expectancy is recorded inconsistently and is usually found in text notes rather than electronic records. Physicians tend to overestimate their own patients’ prognosis which may contribute to lack of documentation. The second and third themes identified barriers that were often conceptually linked. Patient illness severity resulted in symptoms that limited research participation. (Table 1) Patients who were in pain had severe fatigue or nausea simply felt overwhelmed by the demands Atomoxetine HCl of serious illness. Investigators or Atomoxetine HCl CRCs often discussed severity of illness and then linked it to the third theme of physician or caregiver protectiveness. Researchers approached family or nurses to learn if patients were able to discuss participation – and found these individuals were protective to the point of refusal on the patient’s behalf. Investigators and CRCs reported experiences with clinic physicians hospice nurses Atomoxetine HCl and primary care doctors who would not permit recruiting visits because they believed patients would be overly burdened by research participation. A fourth theme was the logistic demands created by seeking patients who were in multiple healthcare settings. (Table 1) Patients with serious illness see multiple providers and frequently transfer from outpatient to inpatient or long-term care settings.24 Staff and investigators reported they had to establish recruitment procedures in many rather than one clinical site and each demanded additional time. Finally investigators discussed lack of resources particularly personnel time as an important fifth barrier to recruiting. They indicated that palliative care research required greater investments in personnel time than non-palliative care clinical trials. Participants also noted the need for systematic preparation and training of personnel to approach palliative care patients and families. Effective Strategies for Recruitment Participating site PIs and CRCs reported numerous strategies they found to be effective to recruit palliative care patients to the statin protocol and to other studies. Themes for effective recruitment included This theme illustrated creative approaches used to reduce the burden of trial participation for palliative care patients therefore making recruitment more feasible. Another recruitment strategy was engagement of clinical champions who assisted with access to patient populations. Interview participants noted Atomoxetine HCl this as an essential role for a PI who would cultivate relationships with clinical leaders and build enthusiasm for the trial. (Table 2) Champions were defined by their ability to give entrée to patients but also by their willingness to introduce the trial to patients or make referrals. Typically this role began with the champion’s scientific interest in the study but sometimes included incentives such as in-service education small gifts of food or (rarely) payments for each successful patient referral. Finally some interview participants noted ways that the PCRC as a research cooperative was a resource to improve clinical trials recruitment. (Table 2) Comments focused on team-based support sharing and disseminated best practices in an on-going clinical trial and learning together from successes. Role of the PCRC to Enhance Recruitment To wrap up each interview respondents were asked if there was any systematic ways.