The Scottish Automated Recruitment Management Application (SARMA) system
Recruitment to clinical trials and observational studies in primary care is often difficult, particularly when clinicians need to identify study participants with acute conditions during consultations. If a study fails to recruit enough patients or clinicians the study is in danger of being scientifically suboptimal because the results may not be in favour of the new treatment or therapy but are still nevertheless unable to rule out the possibility that there is an important benefit. Methods that can support the recruitment process can therefore help to ensure that a study provides scientifically valid results.
SARMA is based on a technology called multi-agent systems, which in the context of supporting recruitment would work as an electronic alerting system that would present a clinician with a list of potentially eligible patients for one or more trials. During a consultation the clinician can discuss with a patient whether he or she would be interested in being contacted by a researcher to discuss participation in the trial. If the patient says yes then an alert (an SMS message or an email) is sent to one of the trial researchers. This alert will contain the patient's name and a contact telephone number. Alternatively a patient may say that he or she does not want to be contacted, in which case no alert is sent. The patient may also request to not be asked again, in which case he or she would be flagged in the system as not wanting to take part in trials.
For an electronic alerting system to support trial recruitment, patients and professionals have to be willing to use it. As with the development of any healthcare intervention, identifying barriers to (ie. potential problems) and facilitators of (things that can help) the proposed change must be part of the process. WIth this in mind we have done the following:
A highly focused literature search to identify articles that have considered barriers and facilitators in the context of electronic alerts and multi-agent systems in healthcare.
Discussed issues around participation in trials and electronic alerting with around 15 patients. We spoke to patients in small focus group meetings or one-to-one interviews.
Several small, practice-based focus groups with GPs and other practice staff.
An email pool of patients, GPs, practice staff and researchers who will comment on the checklists developed in the focus group work.
Potential barriers are time, cost, or concerns about being overwhelmed by pop-ups and text messages. Researchers and GPs were enthusiastic about easier recruitment. The system is currently undergoing tests in Tayside general practices. This work is being funded by the Scottish Collaboration of Trialists project.
More details can be obtained from streweek@mac.com
This page was last updated 20th June 2008.