Best practice guidance for the use of retention strategies in RCTs: results from two consensus development workshops.

Valerie Catherine Brueton, Sally Stenning, Fiona Stevenson, Jayne Tierney, Rait Greta

Research output: Contribution to journalPoster abstractpeer-review

Abstract

Best practice guidance for the use of strategies to improve retention in randomised trials: results from two consensus development workshops
V. Brueton, S.P. Stenning, F. Stevenson, J. Tierney, G. Rait.
Background
Loss to follow-up in randomised clinical trials (RCTs) can lead to biased results. Evidence from a Cochrane review identified that monetary incentives and some postal communication strategies improve retention in RCTs. A related qualitative study found retention strategies are routinely used without knowledge of their effect. As no guidance for the use of retention strategies in RCTs exists, we developed consensus based guidance for the use of retention strategies in RCTs based on the evidence available.
Methods
We used consensus development workshops with trial personnel from two UK Clinical Trials Units to: explore the evidence available for retention in RCTs; identify barriers to the use of retention strategies; develop best practice guidance for the use of retention strategies; and to identify further strategies for evaluation. Each workshop commenced with a presentation of the evidence from a Cochrane review and associated qualitative study followed by discussions on: how convinced workshop participants were by the evidence; barriers to the use of effective strategies; types of RCT follow-up retention strategies could be used for, and retention strategies for future research. Summaries of the group discussion were fed back to workshop participants and agreed consensus on best practice guidance for retention identified.
Results
66 trial personnel attended the workshops. Best practice guidance was agreed for the use of small financial incentives to improve questionnaire response in RCTs and that 2nd class post rather than 1st class post was sufficient to improve postal questionnaire response in RCTs. Barriers to the use of effective retention strategies were: the small absolute benefits seen for the addition of monetary incentives, and perceptions among trialists that some communication strategies are outdated. Furthermore, there was resistance to change existing retention practices thought to be effective. Face to face and electronic follow-up strategies were identified for further research.

Interpretation
The extent of agreement on best practice guidance for the use of retention strategies in RCTs is limited by the variability in the currently available evidence. Potential barriers to the use of effective strategies have been identified. This guidance will need updating as new retention strategies are evaluated.

Original languageEnglish
Article number1.007
Pages (from-to)171-187
Number of pages1
JournalAnnals of Global Health
Volume83
Issue number1
DOIs
Publication statusPublished - Feb 2017

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