Systematic review identifies number of strategies important for retaining study participants
Open accessAbstract
Objective Loss to follow-up threatens internal and external validity yet little research has examined ways to limit participant attrition. We conducted a systematic review of studies with a primary focus on strategies to retain participants in health care research. Study design and settings We completed searches of PubMed, CINAHL, CENTRAL, Cochrane Methodology Register, and EMBASE (August 2005). We also examined reference lists of eligible articles and relevant reviews. A data-driven thematic analysis of the retention strategies identified common themes. Results We retrieved 3,068 citations, 21 studies were eligible for inclusion. We abstracted 368 strategies and from these identified 12 themes. The studies reported a median of 17 strategies across a median of six themes. The most commonly reported strategies were systematic methods of participant contact and scheduling. Studies with retention rates lower than the mean rate (86%) reported fewer strategies. There was no difference in the number of different themes used. Conclusion Available evidence suggests that investigators should consider using a number of retention strategies across several themes to maximize the retention of participants. Further research, including explicit evaluation of the effectiveness of different strategies, is needed.
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Substantial strategies have been found to be effective in improving recruitment, reducing loss to follow-up, and enhancing retention during intervention in some trials.
“Moreover, substantial strategies have been found to be effective in improving recruitment, reducing loss to follow-up, and enhancing retention during intervention in some trials [33-36].”
From Assessing the Effectiveness of Digital Health Behavior Strategies on Type 2 Diabetes Management: Systematic Review and Network Meta-Analysis (2025) · cites this paper as [36]
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“Moreover, substantial strategies have been found to be effective in improving recruitment, reducing loss to follow-up, and enhancing retention during intervention in some trials [33-36].”
- Authors
- Robinson, K. A., Dennison, C. R., Wayman, D. M., Pronovost, P. J., & Needham, D. M.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Robinson, Karen A.
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2007-08
- Volume
- 60
- Issue
- 8
- Pages
- 757.e1-757.e19
- ISSN
- 0895-4356 (ISSN-L)
- PMC
- PMC1997303
- OpenAlex
- W2159625444
- Cited by
- 222
- References
- 0
- Citations by year
- 2026: 9 · 2025: 5 · 2024: 6 · 2023: 14 · 2022: 8 · 2021: 20 · 2020: 19 · 2019: 14 · 2018: 15 · 2017: 16 · 2016: 17 · 2015: 16 · 2014: 12 · 2013: 19 · 2012: 8
- FWCI
- 0.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p50hl073994-05)
- National Heart, Lung, and Blood Institute (P50 HL-073994, P050 HL 73994-01)
- National Institute of Nursing Research (K23NR009193)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- participant retention, loss to follow-up, participant attrition, retention strategies, health care research, appointment scheduling, research participant engagement
- MeSH terms
- Humans, Patient Compliance, Patient Dropouts, Research Design, Cohort Studies, Patient Selection
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