Factors affecting recruitment into depression trials: Systematic review, meta-synthesis and conceptual framework
Open accessAbstract
BACKGROUND: Depression is common and clinical trials are crucial for evaluating treatments. Difficulties in recruiting participants into depression trials are well-documented, yet no study has examined the factors affecting recruitment. This review aims to identify the factors affecting recruitment into depression trials and to develop a conceptual framework through systematic assessment of published qualitative research. METHODS: Systematic review and meta-synthesis of published qualitative studies. Meta-synthesis involves a synthesis of themes across a number of qualitative studies to produce findings that are "greater than the sum of the parts". ASSIA, CINAHL, Embase, Medline and PsychInfo were searched up to April 2013. Reference lists of included studies, key publications and relevant reviews were also searched. Quality appraisal adopted the "prompts for appraising qualitative research". RESULTS: 7977 citations were identified, and 15 studies were included. Findings indicate that the decision to enter a depression trial is made by patients and gatekeepers based on the patient׳s health state at the time of being approached to participate; on their attitude towards the research and trial interventions; and on the extent to which patients become engaged with the trial. Our conceptual framework highlights that the decision to participate by both the patient and the gatekeeper involves a judgement between risk and reward. LIMITATIONS: Only English language publications were included in this review. CONCLUSIONS: Findings from this review have implications for the design of interventions to improve recruitment into depression trials. Such interventions may aim to diminish the perceived risks and increase the perceived rewards of participation.
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Difficulties in recruiting participants into depression trials are very common.
“difficulties in recruiting participants into depression trials are very common [32]”
From Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial (2023) · cites this paper as [32]
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4 of the 158 references couldn’t be matched to a known paper.
Research works printed but not linked: 4
- 1. Depression/ 2. Depressive disorder/ 3. Dysthymic disorder/ 4. Mood disorder/ 5. or/1-4 1. 69,314 2. 55,773 3. 935 4. 10,109 5. 13,1621 Phenomenon of interest: to increase specificity the "recruitment" text word terms only identify publications that refer to the terms more than twice. This was a strategy used in the most recent Cochrane review (Treweek et al., 2013). 6. Research subject/ 7. Patient participation/ 8. Patient selection/ 9. Enrol?n.ab. /freq¼ 2 10. recruitn.ab. /freq¼2 11. Participatn.ab. /freq¼ 2 12. Enlistn.ab. /freq¼2 13. Informed consent.tw. 14. Informed consent/ 15. or/6-14 6. 4756 7. 16,563 8. 45,870 9. 18,050 10. 29,625 11. 37,227 12. 200 13. 19,713 14. 30,084 15. 17,9749
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“Finally, as difficulties in recruiting participants into depression trials are very common [32], we aimed to test whether a previously used recruitment method would be feasible for this novel study population.”
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- Authors
- Hughes-Morley, A., Young, B., Waheed, W., Small, N., & Bower, P.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- University of Liverpool (GB)
- Corresponding author
- Hughes-Morley, Adwoa
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 172
- Pages
- 274-290
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2152217926
- Cited by
- 132
- References
- 158
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 14 · 2023: 5 · 2022: 11 · 2021: 20 · 2020: 18 · 2019: 8 · 2018: 14 · 2017: 12 · 2016: 10 · 2015: 4
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by-nc-nd)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Funders
- National Institute for Health Research (NIHR)
- Doctoral Research Fellowship (DRF-2012-05-128)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Keywords
- depression, clinical trial recruitment, clinical trial participation, patient decision-making, gatekeepers, attitudes toward research, conceptual framework
- MeSH terms
- Depressive Disorder, Health Status, Humans, Patient Selection, Control Groups, Qualitative Research
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