The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.
Clinical trials: the challenge of recruitment and retention of participants
Abstract
AIMS AND OBJECTIVES: This article, based on the available literature, attempts to discuss the importance of recruitment and retention of research participants, the associated barriers and challenges, and various strategies to overcome these barriers. BACKGROUND: The inability to recruit and retain the required participants in a research project poses serious threats to both the internal and the external validity of a research study. Despite serious implications, the issues of recruitment and retention do not receive due attention in research and publications. Literature suggests a lack of coordinated efforts to collect information on the outcomes of recruitment experiences in clinical trials and population studies. Studies often mention the number of participants who refuse to participate; however, the majority of the studies often fail to mention the specific reasons insufficient recruitment or retention of the participants. DESIGN: A methodological paper. METHOD: Various participant-, context-, environment- and research-related factors are examined that affect the phenomenon of recruitment and retention of the participants in a study. RESULTS: Delayed or inefficient recruitment also has financial and ethical implications. Although there are many pieces of information scattered throughout academic journals on recruitment and retention of participants in research, few authors have dealt with the issue holistically. It is imperative for researchers to understand the importance of recruitment and retention of research participants, the associated barriers and challenges, and various strategies to overcome these barriers. CONCLUSION: Appropriate recording and reporting of the problems faced while recruiting and retaining the participants in research studies can help not only in understating the challenge, but will also help in devising the strategies to overcome this problem. This article was an attempt to synthesise and review the available literature on recruitment and retention issues, which demand extensive theoretical and conceptual thinking as part of the research design. RELEVANCE TO PRACTICE: An understanding of the challenges and issues related to recruitment and retention can help researchers to think ahead about the strategies to overcome these issues and consequently save the time and energy of the participants, researchers and funding agencies.
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“Problems with recruitment and retention in clinical trials have been described in the literature [58] and account also for this study where attrition was very high.”
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Cites
Quasi-experimentation: Design and analysis issues for field settings
Shrout, P. E. (1980) · Evaluation and Program Planning · doi:10.1016/0149-7189(80)90063-4 · Cited by 6,091
Nursing Research: Principles and Methods
Marrone, S. R. (1987) · AORN Journal · doi:10.1016/s0001-2092(07)69731-2 · Cited by 3,240
Mental health stigma as social attribution: Implications for research methods and attitude change.
Corrigan, P. W. (2000) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.7.1.48 · Cited by 954 · cited 1×
“This could result in a resistance, reluctance or refusal to participate in a research study (Corrigan 2000, Moore et al. 2000, Gross & Fogg 2001).”
BackgroundDesigning clinical research: An epidemiologic approach
Hulley, S., Cummings, S., & Browner, W. (1989) · Controlled Clinical Trials · doi:10.1016/0197-2456(89)90023-8 · Cited by 946
Assessing the non-random sampling effects of subject attrition in longitudinal research
Goodman, J. S., & Blum, T. C. (1996) · Journal of Management · doi:10.1177/014920639602200405 · Cited by 766
Challenges in recruitment of research participants
Patel, M. X., Doku, V. C. K., & Tennakoon, L. (2003) · Advances in Psychiatric Treatment · doi:10.1192/apt.9.3.229 · Cited by 519
Recruitment for controlled clinical trials: Literature summary and annotated bibliography
Lovato, L., Hill, K., Hertert, S., Hunninghake, D. B., & Probstfield, J. L. (1997) · Controlled Clinical Trials · doi:10.1016/s0197-2456(96)00236-x · Cited by 400
Factors that limit the quality, number and progress of randomised controlled trials
Prescott, Counsell, Gillespie, Grant, Russell, Kiauka, Colthart, Ross, Shepherd, & Russell (1999) · Health Technology Assessment · doi:10.3310/hta3200 · Cited by 390
The importance of conducting and reporting pilot studies: the example of the Scottish Births Survey
van Teijlingen, E., Rennie, A. M., Hundley, V. A., & Graham, W. J. (2001) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2001.01757.x · Cited by 365
Increasing recruitment to randomised trials: a review of randomised controlled trials
Watson, J. M., & Torgerson, D. J. (2006) · BMC Medical Research Methodology · doi:10.1186/1471-2288-6-34 · Cited by 333
Research works printed but not linked: 4
- Audley T, 1995, Study site co‐ordinators: a ‘job definition’ challenge, Clinical Research Focus, 6, 12
- High R, 2001, Important factors in designing statistical power analysis studies, Computing News
- Polit DF, 2001, Essential of Nursing Research: Methods, Appraisal, and Utilization
- Puffer S, 2003, Recruitment difficulties in Randomised Controlled Trials, Controlled Clinical Trials, 24, 214
Cited by
Sorted by citations
Items 401–453 of 453
Passa, A.-M. D., Prokop-Millar, S., Yaya, H., Vandehei, E., McIntyre‐Wood, C., Fein, A. J., MacKillop, E., MacKillop, J. M., & Duarte, D. G. G. (2025) · Brazilian Journal of Psychiatry · doi:10.47626/1516-4446-2025-4168
Chambers, L. C., Giguere, T., Welwean, R., Peachey, A. M., Wiehe, S. E., Aalsma, M. C., Ranney, M. L., & Beaudoin, F. L. (2025) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2025.112923
Despert, H., Oppikofer, C., Dupuy, F., Henry, G., Delay, E., & Mojallal, A. A. (2025) · Research Square · doi:10.21203/rs.3.rs-7106706/v1
Schoffl, J., Arora, M., Pozzato, I., McBain, C., Rodrigues, D., Vafa, E., Middleton, J. W., Davis, G. M., Bourke, J., Krassioukov, A. V., et al. (2025) · BMC Neurology · doi:10.1186/s12883-025-04423-x
Udupa, S., Beydoun, S. A., Kifell, J., Duong, J., Abdallah, J. P., Ohana, M., & Goldfarb, M. (2025) · Australian Critical Care · doi:10.1016/j.aucc.2025.101472
Rahman, M. M., Saif, M. S. I., Beall, J., Martin, R. H., Rockswold, G. L., Barsan, W. G., Korley, F. K., Silbergleit, R., Stevenson, V., & Gajewski, B. J. (2025) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2025.101586
Patient perspectives of patient engagement in medicine development: a qualitative study
Auwal, F., Clark, E. J., Copeland, C. S., & McClelland, G. R. (2025) · Current Medical Research and Opinion · doi:10.1080/03007995.2025.2605694
Crotty, K. (2014) · University of Hertfordshire Research Archive (University of Hertfordshire) · doi:10.18745/th.15431
Tew, M., Catchpool, M., Furler, J., Rue, K. D. L., Clarke, P., Manski-Nankervis, J.-A., & Dalziel, K. (2023) · Figshare · doi:10.6084/m9.figshare.22624048
Marthinsen, G. N., Helseth, S., Småstuen, M., Bjorvatn, B., Bandlien, S. M., & Fegran, L. (2022) · Figshare · doi:10.6084/m9.figshare.20252804
Tew, M., Catchpool, M., Furler, J., Rue, K. D. L., Clarke, P., Manski-Nankervis, J.-A., & Dalziel, K. (2023) · Figshare · doi:10.6084/m9.figshare.22624054
Murphy, E. K., Shiely, F., & Treweek, S. (2022) · Figshare · doi:10.6084/m9.figshare.19759932
Rafee, A., Riepenhausen, S., Neuhaus, P., Meidt, A., Dugas, M., & Varghese, J. (2022) · Figshare · doi:10.6084/m9.figshare.19767797
Donaghy, B., Green, H., Heyes, K., & Keenan, J. (2024) · e-space (Manchester Metropolitan University) · doi:10.57874/f5dj-e226
Tew, M., Catchpool, M., Furler, J., Rue, K. D. L., Clarke, P., Manski-Nankervis, J.-A., & Dalziel, K. (2023) · Figshare · doi:10.6084/m9.figshare.22624051
Tew, M., Catchpool, M., Furler, J., Rue, K. D. L., Clarke, P., Manski-Nankervis, J.-A., & Dalziel, K. (2023) · Figshare · doi:10.6084/m9.figshare.22624042
Murphy, E. K., O’Keeffe, A., O Shea, N., Long, E. B., Eustace, J. A., & Shiely, F. (2021) · Figshare · doi:10.6084/m9.figshare.16576031
Boeker, M., Zöller, D., Blasini, R., Macho, P., Helfer, S., Behrens, M., Prokosch, H.-U., & Gülden, C. (2024) · Figshare · doi:10.6084/m9.figshare.26681749
Zabaleta‐del‐Olmo, E., Casajuana‐Closas, M., López‐Jiménez, T., Pombo, H., Pons‐Vigués, M., Ribera, E. P., Cabezas-Peña, C., Llobera, J., Martí‐Lluch, R., Vicens, C., et al. (2021) · Figshare · doi:10.6084/m9.figshare.17126185
Zabaleta‐del‐Olmo, E., Casajuana‐Closas, M., López‐Jiménez, T., Pombo, H., Pons‐Vigués, M., Ribera, E. P., Cabezas-Peña, C., Llobera, J., Martí‐Lluch, R., Vicens, C., et al. (2021) · Figshare · doi:10.6084/m9.figshare.17126188
Shiely, F., Murphy, D., & Millar, S. (2023) · Figshare · doi:10.6084/m9.figshare.23707049
Marthinsen, G. N., Helseth, S., Småstuen, M., Bjorvatn, B., Bandlien, S. M., & Fegran, L. (2022) · Figshare · doi:10.6084/m9.figshare.20252813
Marthinsen, G. N., Helseth, S., Småstuen, M., Bjorvatn, B., Bandlien, S. M., & Fegran, L. (2022) · Figshare · doi:10.6084/m9.figshare.20252801
MacLachlan, A., Crawford, K., Shinwell, S., Nixon, C., & Henderson, M. (2021) · Figshare · doi:10.6084/m9.figshare.14795200
Tan, N. H., Lafeber, M., Sablerolles, R. S. G., Veerman Roders, I., van de Hoef, A., van Grafhorst, K., Visser, L. G., Postma, D. F., Goorhuis, A., Rietdijk, W. J. R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26507242
Foucher, J., Azizi, L., Öijerstedt, L., Kläppe, U., & Ingre, C. (2024) · Figshare · doi:10.6084/m9.figshare.26710691
Tew, M., Catchpool, M., Furler, J., Rue, K. D. L., Clarke, P., Manski-Nankervis, J.-A., & Dalziel, K. (2023) · Figshare · doi:10.6084/m9.figshare.22624045
Zabaleta‐del‐Olmo, E., Casajuana‐Closas, M., López‐Jiménez, T., Pombo, H., Pons‐Vigués, M., Ribera, E. P., Cabezas-Peña, C., Llobera, J., Martí‐Lluch, R., Vicens, C., et al. (2021) · Figshare · doi:10.6084/m9.figshare.17126191
O’Brien, E. C., Raman, S. R., Ellis, A. M., Hammill, B. G., Berdan, L. G., Rorick, T. L., Janmohamed, S. G., Lampron, Z. M., Hernandez, A. F., & Curtis, L. H. (2021) · Figshare · doi:10.6084/m9.figshare.15020753
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Bolikal, P. D., Schuetter, R., Guzman, T., Patel, R., Gubanich, P., Wade, S. L., Babcock, L., Narad, M. E., Eickmeyer, S. M., & Kurowski, B. G. (2025) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2025.100539
Cooper, K. G., Constable, L., Vadiveloo, T., Matuluko, A., Kennedy, C., McCann, S., Cotton, S. C., Gillies, K., Bruce, R., Smith, P., et al. (2025) · Health Technology Assessment · doi:10.3310/gjkc5715
Goodyke, M. P., Davis, A., Rivera, E., Tintle, N., Hrynyk, H. P., & Dunn, S. L. (2026) · Nursing Research · doi:10.1097/nnr.0000000000000896
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Sharma, A., Yashita, Tripathi, Y., Sharma, C., Sharma, A., & Verma, M. K. (2025) · Global AI Summit - International Conference on Artificial Intelligence and Emerging Technology (AI Summit) · doi:10.1109/aisummit66170.2025.11410905
Ampofo, B. K., & Arthur, M. S. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1785490
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Øverby, N. C., Medin, A. C., Valen, E. N., Salvesen, L., Vik, F. N., & Hillesund, E. R. (2026) · Proceedings of The Nutrition Society · doi:10.1017/s0029665126102286
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Perez, A., Dawood, K., Kadri, R., Muladore, R., Degner, A., Chen, D., Harris, D., Levy, P. D., Buis, L. R., & Guetterman, T. C. (2026) · Journal of Clinical and Translational Science · doi:10.1017/cts.2026.10738
Summar, M. L., & Woodcock, J. (2026) · Clinical and Translational Science · doi:10.1111/cts.70551
Jakobsson, T., Lauruschkus, K., Johnsson, B. A., Andersson, Å., Hansson, O., Holmberg, R. G., & Tornberg, Å. B. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1811789
Villalón, F., & Escaffi‐Schwarz, M. (2026) · Journal of Medical Internet Research · doi:10.2196/87416
Mghanga, S., Mtenga, A. E., Pasape, L., & Olotu, A. (2026) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph23050633
Vaughn, A. M., Gale, M., Kulbeth, D., Featherman, N., Craig, H., Kardel, S., Windebank, B. M., Webb, C., Adgate, J. L., Wilkening, G., et al. (2026) · Journal of Public Health Management and Practice · doi:10.1097/phh.0000000000002374
Dunn, S., Weber, B. A., Studer, D., Manataki, A., Bally, L., Bach, B., & Capel, T. (2026) · Designing Interactive Systems Conference · doi:10.1145/3800645.3812943
Kavaklı, N., Öztürk, N., & Vinte, J. V. (2026) · Uluslararası Eğitim Araştırmacıları Dergisi · doi:10.52134/ueader.1902732
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Attoh-Mensah, E. (2026) · Frontiers research topics · doi:10.3389/978-2-8325-8492-7
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Frausing, K. P., Flammild, M. H., Jakobsen, G., Mikkelsen, M. S., Dahl, E., Sørensen, D., Rønn-Smidt, H., & Dahlgaard, J. (2026) · Research Square · doi:10.21203/rs.3.rs-10520197/v1
Marvin, L., Rayner, R., Gardiner, C., Petancevski, E. L., & Fransen, J. (2026) · doi:10.51224/sportrxiv.1036
Orechwa, A., Wolfe, N., Hoffman, B. L., Karimipour, N., Folb, K. L., Rogers, A. A., Watson-Currie, E. L., Jauriqui, V., Valkenburgh, S. P. V., Giaccardi, S., et al. (2026) · JMIR Research Protocols · doi:10.2196/95734
Metadata
- Authors
- Gul, R. B., & Ali, P. A.
- Affiliations
- Aga Khan University (PK)
- Corresponding author
- Gul, Raisa B
- ORCID
- Ali, Parveen A
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2009-12-17
- Volume
- 19
- Issue
- 1-2
- Pages
- 227-233
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W2034893913
- Cited by
- 449
- References
- 58
- Citations by year
- 2026: 18 · 2025: 36 · 2024: 40 · 2023: 40 · 2022: 44 · 2021: 47 · 2020: 35 · 2019: 29 · 2018: 33 · 2017: 25 · 2016: 18 · 2015: 17 · 2014: 25 · 2013: 17 · 2012: 12
- FWCI
- 8.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Health Sciences › Nursing › Research and Theory › Methodologies in Health Research and Practice
- Keywords
- clinical trial recruitment, participant retention, recruitment barriers, recruitment strategies, internal and external validity, research ethics
- MeSH terms
- Clinical Trials as Topic, Female, Humans, Male, Patient Dropouts, Nursing Research, Patient Selection
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