Introduction
Failure to recruit is a common problem in RCTs
(randomized controlled trials) in primary care
(Tognoni et al., 1991; Hunt et al., 2001) and is the
main reason for the failure of trials. It is reported
that 66% of trials never reach their projected sam-
ple size and the losses are often due to refusal
of doctors or patients to participate (Charlson and
Horowitz, 1984). Factors such as overwork and
forgetfulness are reasons which are often given for
general practitioners’ (GPs) refusal to participate
in the first instance or to fail to recruit any patients
even if they have originally agreed to participate
in a study (Murphy et al., 1992).
It has been claimed that the majority of GPs are
not interested in research (Silargy and Carson,
1989), and it is suggested that RCTs are much
Primary Health Care Research & Development 2007; 8: 264–270
doi: 10.1017/S146342360700031X
© 2007 Cambridge University Press
Achieving target recruitment in a primary
care trial: lessons from PRIDE*
Carolyn A. Chew-Graham School of Community Based Medicine, University of Manchester, UK, Karina Lovell School
of Nursing, University of Manchester, UK, Chris Roberts School of Epidemiology and Health Sciences, University of
Manchester, UK, Bob Baldwin Manchester Mental Health and Social Care Trust (MMHSCT), Manchester Royal
Infirmary, Manchester, UK, Michael Morley MMHSCT, Manchester, UK, Alistair Burns MMHSCT, Wythenshawe
Hospital, Manchester, UK and Heather Burroughs School of Community Based Medicine, University of Manchester,
Manchester, UK
Background: Failure to reach recruitment targets is a widespread problem in RCTs (ran-
domized controlled trials). This paper presents experience of recruiting patients into the
PRIDE trial which was carried out in one Primary Care Trust (PCT) in the North West of
England. Aim: The aim of this feasibility study was to test the effectiveness of a new
model of care for the management of late-life depression. Method: GPs (general practi-
tioners), PNs (practice nurses) and community nurses were invited to refer patients into
the study. Over 100 patients were needed (at least 50 in each arm of the trial) for the study
to be sufficiently powered. On-target recruitment of over 100 patients over 18 months
was achieved. Findings: Data obtained from conversations and from semi-structured
interviews with health professionals is presented to give possible explanations for this
successful recruitment. Not all practices in the PCT engaged with the study, and the most
common reasons given by GPs and their staff for non-participation was being single
handed or already having a heavy work-load. All community nurses spoken to agreed to
refer patients to the study but only five referrals were made by this group over the course
of the study. The main reasons primary care professionals did agree to participate and
continue to refer patients was that they felt the trial was offering a local and relevant ser-
vice to an under-served patient group.The very simple referral process was also an import-
ant factor. In addition, the Trial Nurse was perceived to be responsive, responding quickly
to referrals made and providing regular and detailed feedback which was perceived to
help and support the health professionals in the future management of the patient.
Key words: recruitment to trials; referral process; trials; under-served groups
Received: March 2006; accepted: March 2007
Address for correspondence: Dr Carolyn A. Chew-Graham,
School of Community Based Medicine, Rusholme Health
Centre, Walmer Street, Manchester M14 5NP, UK. Email:
cchew@manchester.ac.uk
* PRIDE trial (PRimary care Intervention in Depression in the
Elderly) funded by Department of Health.
ISRCTN630361331
EudraCT number 2005-003653-27
These views are not necessarily those of the funders.
https://www.cambridge.org/core/terms. https://doi.org/10.1017/S146342360700031X
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