Cited by 144Ethics in Clinical ResearchHealth Policy Implementation ScienceMental Health and Patient Involvement

The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.

The research burden of randomized controlled trial participation: a systematic thematic synthesis of qualitative evidence

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Abstract

BACKGROUND: Participation in randomized controlled trials (RCTs) may be quite demanding and could represent an important burden for patients. We aimed to explore this research burden (i.e., the psychological, physical, and financial burdens) experienced by patients through their participation in a RCT. METHODS: We conducted a systematic review of qualitative studies exploring adult patients' experiences with RCT participation. We searched MEDLINE (PubMed), CINAHL, PSYCHINFO, and Embase (search date March 2018) for eligible reports. Qualitative data coding and indexing were assisted by NVivo. The quality of reports was assessed by using the Critical Appraisal Skills Program (CASP) tool. RESULTS: We included 45 qualitative studies that involved 1732 RCT participants. Important psychological burdens were identified at every stage of the trial process. Participants reported feeling anxiety and being afraid of "being a 'guinea pig'" and described undergoing randomization and allocation to a placebo as particularly difficult resulting in disappointment, anger, and depression. Patients' follow-up and trial closure were also responsible for a wide range of psychological, physical, and financial burdens. Furthermore, factors related to burdensome impacts and consequences were discerned. These factors involved trial information, poorly organized and too-demanding follow-up, and lack of appropriate management when the patient's participation ended. Trial participation was also associated with beneficial effects such as the satisfaction of feeling "useful," gaining "a sense of control," and receiving special attention. CONCLUSIONS: Our finding provides a detailed description of research burden across the whole RCT process. Many of the burdens described could be anticipated, and some avoided in a movement toward minimally disruptive clinical research. Such an approach could improve trial recruitment and retention. REVIEW REGISTRATION: PROSPERO CRD42018098994.

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Crossref · 10.1186/s12916-019-1476-5

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Fig. 1 Systematic review flowchart
Fig. 1 Systematic review flowchartCC BY · PubMed Central
Fig. 2 Classification of theme “Research Burden” and sub-themes “Burdensome Impacts and Consequences” and “Factors related to Burden”
Fig. 2 Classification of theme “Research Burden” and sub-themes “Burdensome Impacts and Consequences” and “Factors related to Burden”CC BY · PubMed Central

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Research works printed but not linked: 2

  1. Booth A: Chapter 3: searching for studies. In: Supplementary guidance for inclusion of qualitative research in Cochrane systematic reviews of interventions. Edited by Noyes J BA, Hannes K, Harden A, Harris J, Lewin S, Lockwood C, vol. version 1 (updated August 2011): Cochrane Collaboration Qualitative Methods Group, 2011; 2011.
  2. Lingler JH, Schmidt KL, Gentry AL, Hu L, Terhorst LA. A new measure of research participant burden: brief report. J Empir Res Hum Res Ethics. 2014;9(4):46–9. · DOI

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Metadata

Authors
Naidoo, N., Nguyen, V. T., Ravaud, P., Young, B., Amiel, P., Schanté, D., Clarke, M., & Boutron, I.
Affiliations
  • Inserm (FR)
  • University of Liverpool (GB)
  • Institut National du Cancer (FR)
  • Queen's University Belfast (GB)
Corresponding author
Boutron, Isabelle
Venue
BMC Medicine
Published
2020-01-20
Volume
18
Issue
1
Pages
6-6
ISSN
1741-7015 (ISSN-L)
OpenAlex
W2999900278
Cited by
144
References
53
Citations by year
2026: 27 · 2025: 22 · 2024: 19 · 2023: 18 · 2022: 22 · 2021: 30 · 2020: 6
FWCI
3.18
Type
journal article
Language
en
Open access
Locations
  • BMC Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Columbia Academic Commons (Columbia University)
Funders
Institut National Du Cancer
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
Keywords
research burden, randomized controlled trials, patient experience, psychological burden, physical burden, financial burden, trial follow-up, trial closure, randomization, trial recruitment, trial retention
MeSH terms
Humans, Volunteers, Randomized Controlled Trials as Topic, Cost of Illness, Qualitative Research

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