Cited by 132Ethics in Clinical ResearchMental Health Treatment and AccessMental Health and Patient Involvement

Factors affecting recruitment into depression trials: Systematic review, meta-synthesis and conceptual framework

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Hughes-Morley, Adwoa, Young, Bridget, Waheed, Waquas, Small, Nicola, Bower, Peter·2015·Journal of Affective Disorders

Abstract

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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  1. 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
  2. Higgins, J., Green, S. (Eds.), 2011. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, Chichester, UK ([Updated March 2011]).
  3. Minas, H., Klimidis, S., Kokanovic, R., 2005. Mental health research in general practice. Australas. Psychiatry 13 (2), 181-184.
  4. Parry, G. & Barkham, M., 2009. Trials & tribulations: towards better design and practice in psychological therapy trials. In: Proceedings of the Society for Social Medicine Conference. Sheffield, UK.

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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
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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