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Why is it so difficult to recruit patients to research in emergency care? Lessons from the AHEAD study
  1. Rowena Johnson1,
  2. Maxine Kuczawski2,
  3. Suzanne Mason2
  1. 1Medical School, The University of Sheffield, Sheffield, UK
  2. 2School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
  1. Correspondence to Rowena Johnson, The Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX rmjohnson1{at}


Introduction In February 2014, all 23 National Institute for Health Research medical research specialities were failing to meet recruitment targets, with ‘Injuries and Emergencies’ research performing particularly poorly. In this paper, the multicentre AHEAD study was used to explore issues surrounding recruitment in UK emergency departments.

Method The AHEAD study investigated management and outcomes in over 3000 anticoagulated patients who suffered a head injury. Data from the study were used to compare patient recruitment at 33 Type-1 emergency departments. A questionnaire was sent to a research nurse at each of these sites and 30 replied (91% response rate). The survey investigated the difficulties encountered during patient recruitment and whether these were related to recruitment methods. More detailed interviews were conducted with three research nurses, to gain further insight into the barriers and facilitators involved.

Results Overall recruitment varied widely between sites with an eightfold variation in recruitment rates. Population demographics and other uncontrollable factors will partly contribute to this variation. However, research nurses reported many problems, including site resources, lack of staff engagement and flaws in recruitment strategies, which could be improved.

Conclusions Many of the barriers to recruiting patients for research studies encountered by research nurses have previously been reported in the literature, but there remain consistent problems. Until solutions are found, researchers will continue to miss recruitment targets and this will have implications for the efficiency and quality of emergency medicine research in the UK.

  • research, methods
  • emergency departments

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