Host: Centre for Primary Care, Institute of Population Health
About the event:
Speaker 1: Adwoa Hughes-Morley (NIHR Doctoral Research Fellow, Centre for Primary Care
Institute of Population Health, University of Manchester)
Title: Factors affecting recruitment into depression trials: systematic review and meta-synthesis of qualitative evidence
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 comprehensively examined the factors affecting recruitment. The objective of this review is to identify the factors affecting recruitment into depression trials through systematic assessment of published qualitative research.
Systematic review and meta-synthesis of published qualitative studies. Meta synthesis reconceptualises themes across a number of qualitative studies to produce findings that are “greater than the sum of the parts”. Medline, Embase, PsychInfo and CINAHL were searched up to April 2013. Reference lists of included studies, key publications and relevant reviews were also searched. Quality appraisal adopted the minimally prescriptive “Prompts for appraising Qualitative Research”, combined with appraisal of contribution and credibility during the synthesis process.
7977 citations were identified, and 19 studies are included. Preliminary themes in the identified studies include both barriers and facilitators. Barriers include endorsement of depression symptoms; stigma; the difficulty of introducing the idea of research in a consultation involving depression; protecting the vulnerable patient; and trial related issues (trial burden, treatment preferences, and randomisation). Facilitators include altruism; practical support for participation; access to services to meet mental health needs; clear processes, and; regular feedback to recruiting clinicians. The meta-synthesis (in progress) will seek to develop a broader explanatory framework to better understand barriers to participation.
It is hoped that the explanatory framework will enable the development and evaluation of recruitment strategies that address these factors to improve recruitment into depression trials.
'Speaker 2: Lisa Brunton (MRC Industrial CASE PhD Student, Centre for Primary Care, Institute of Population Health, University of Manchester)
Title: An experience-based analysis of barriers to the adoption of telehealthcare technologies in UK healthcare: a case study on COPD
As more people live with long term conditions (LTC) and live for longer, so the demand for health and social care services increases. One LTC placing significant burden on NHS resources is Chronic Obstructive Pulmonary Disease (COPD). Telehealthcare technologies have been promoted to reduce the demand for expensive hospital/residential care whilst helping people to live an independent life for longer. Previous research suggests telehealthcare can be beneficial in the management of COPD but there remain barriers and challenges to implementing such technologies into routine care. When previous research has been conducted, it has most often been done at a late stage when technologies have already been developed, with little attention being paid to the views of potential users of the technology.
Aim: The aim of this industrial CASE PhD study (in collaboration with Philips Research UK) is to explore barriers to adoption of telehealthcare and initiate user driven solutions in the planning and developing of new or existing telehealthcare devices, thereby bridging the gap between technological development of telehealthcare and its delivery into routine practice.
Methods: The study will employ various qualitative methods (such as interviews, focus groups and observations) to explore the challenges of living with and managing COPD and explore how symptom experience and disease progression impact on the individual needs of patients to identify what types of telehealthcare technology solutions can best support in the management of the condition at different stages. Drawing on techniques of action research, a collaborative working group (made up of patients with COPD, their carers, clinicians directly involved in their care) will be formed and encouraged to contribute to all stages of the primary research study.