Recruitment of emergency department patients to a prospective observational study.

Asymptomatic hypertension Diversity Emergency research Feasibility Health equity Hypertension Prospective observational Racial and ethnic diversity Recruitment

Journal

International journal of emergency medicine
ISSN: 1865-1372
Titre abrégé: Int J Emerg Med
Pays: England
ID NLM: 101469435

Informations de publication

Date de publication:
07 Oct 2024
Historique:
received: 16 05 2024
accepted: 15 09 2024
medline: 8 10 2024
pubmed: 8 10 2024
entrez: 7 10 2024
Statut: epublish

Résumé

The dynamic environment of the emergency department (ED) poses unique challenges to the execution of well-designed research. There is limited investigation into the viability of studies conducted in the ED. This paper offers a systematic evaluation of our recruitment of emergency patients for a prospective observational research study, shedding light on the intricate landscape of research feasibility within the ED setting. Research coordinators dedicated 2816.83 h to screening, recruiting, and enrolling patients between June 2018 and September 2023, having to stop recruitment twice due to financial constraints and the COVID-19 pandemic. 485 patients were approached and 84 of them were enrolled, resulting in a 31.94% enrollment rate, with approximately 2.8 participants recruited per month. Of those enrolled, 77 completed all study endpoints. Most participants were Hispanic (n = 44; 52.3%) and/or Black (n = 37; 44%), middle-aged (µ = 51.7 years), and female (n = 48; 57.1%). Participant recruitment was challenged by competing mindsets, the COVID-19 pandemic, and high staff turnover. Recruiting emergency patients for a prospective observational study is feasible given adequate staffing and financial resources. Standardizing feasibility assessments for the recruitment of patients in the emergency department is important to the success of future study.

Sections du résumé

BACKGROUND BACKGROUND
The dynamic environment of the emergency department (ED) poses unique challenges to the execution of well-designed research. There is limited investigation into the viability of studies conducted in the ED. This paper offers a systematic evaluation of our recruitment of emergency patients for a prospective observational research study, shedding light on the intricate landscape of research feasibility within the ED setting.
RESULTS RESULTS
Research coordinators dedicated 2816.83 h to screening, recruiting, and enrolling patients between June 2018 and September 2023, having to stop recruitment twice due to financial constraints and the COVID-19 pandemic. 485 patients were approached and 84 of them were enrolled, resulting in a 31.94% enrollment rate, with approximately 2.8 participants recruited per month. Of those enrolled, 77 completed all study endpoints. Most participants were Hispanic (n = 44; 52.3%) and/or Black (n = 37; 44%), middle-aged (µ = 51.7 years), and female (n = 48; 57.1%). Participant recruitment was challenged by competing mindsets, the COVID-19 pandemic, and high staff turnover.
CONCLUSIONS CONCLUSIONS
Recruiting emergency patients for a prospective observational study is feasible given adequate staffing and financial resources. Standardizing feasibility assessments for the recruitment of patients in the emergency department is important to the success of future study.

Identifiants

DOI: 10.1186/s12245-024-00717-y PMID: 39375594
pubmed: 39375594
doi: 10.1186/s12245-024-00717-y
pii: 10.1186/s12245-024-00717-y
doi:

Types de publication

Journal Article

Langues

eng

Pagination

142

Subventions

Organisme : NCATS NIH HHS
ID : UL1TR004419
Pays : United States

Informations de copyright

© 2024. The Author(s).

Références

Shea S, Thomas Bigger J, Campion J, Fleiss JL, Rolnitzky LM, Schron E et al. Enrollment in clinical trials: Institutional factors affecting enrollment in the Cardiac Arrhythmia Suppression Trial (CAST). Controlled Clinical Trials [Internet]. 1992 Dec [cited 2023 Nov 15];13(6):466–86. https://linkinghub.elsevier.com/retrieve/pii/019724569290204D
Bjornson-Benson WM, Stibolt TB, Manske KA, Zavela KJ, Youtsey DJ, Sonia Buist A. Monitoring recruitment effectiveness and cost in a clinical trial. Controlled Clinical Trials [Internet]. 1993 Apr [cited 2023 Nov 15];14(2):52–67. https://linkinghub.elsevier.com/retrieve/pii/0197245693900248
Durkin DA, Kjelsberg MO, Sonia Buist A, Connett JE, Owens GR. Recruitment of participants in the Lung Health Study, I: Description of Methods. Controlled Clinical Trials [Internet]. 1993 Apr [cited 2023 Nov 15];14(2):20–37. https://linkinghub.elsevier.com/retrieve/pii/0197245693900226
Williams GH. Funding for Patient-Oriented Research: Critical Strain on a Fundamental Linchpin. JAMA [Internet]. 1997 Jul 16 [cited 2023 Nov 22];278(3):227. http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1997.03550030067036
Cofield SS, Conwit R, Barsan W, Quinn J. Recruitment and Retention of Patients into Emergency Medicine Clinical Trials. Academic Emergency Medicine [Internet]. 2010 Oct [cited 2023 Nov 8];17(10):1104–12. https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1111/j.1553-2712.2010.00866.x
George S, Duran N, Norris K. A Systematic Review of Barriers and Facilitators to Minority Research Participation Among African Americans, Latinos, Asian Americans, and Pacific Islanders. Am J Public Health [Internet]. 2014 Feb [cited 2023 Nov 8];104(2):e16–31. https://doi.org/10.2105/AJPH.2013.301706
Oh SS, Galanter J, Thakur N, Pino-Yanes M, Barcelo NE, White MJ et al. Diversity in Clinical and Biomedical Research: A Promise Yet to Be Fulfilled. PLoS Med [Internet]. 2015 Dec 15 [cited 2023 Nov 8];12(12):e1001918. https://doi.org/10.1371/journal.pmed.1001918
Wendler D, Kington R, Madans J, Wye GV, Christ-Schmidt H, Pratt LA et al. Are Racial and Ethnic Minorities Less Willing to Participate in Health Research? Gill P, editor. PLoS Med [Internet]. 2005 Dec 6 [cited 2023 Nov 22];3(2):e19. https://doi.org/10.1371/journal.pmed.0030019
Durant RW, Wenzel JA, Scarinci IC, Paterniti DA, Fouad MN, Hurd TC, et al. Perspectives on barriers and facilitators to minority recruitment for clinical trials among cancer center leaders, investigators, research staff, and referring clinicians: enhancing minority participation in clinical trials (EMPaCT). Cancer. 2014;120(0 7):1097–105. https://doi.org/10.1002/cncr.28574
Barrett NJ, Ingraham KL, Hawkins TV, Moorman PG. Engaging African Americans in Research: The Recruiter’s Perspective. Ethn Dis [Internet]. 2017 Dec 7 [cited 2023 Nov 22];27(4):453. https://www.ethndis.org/edonline/index.php/ethndis/article/view/753
Razon N, Hessler D, Bibbins-Domingo K, Gottlieb L. How Hypertension Guidelines Address Social Determinants of Health: A Systematic Scoping Review. Medical Care [Internet]. 2021 Dec [cited 2023 Nov 22];59(12):1122–9. https://journals.lww.com/ https://doi.org/10.1097/MLR.0000000000001649
Stewart AL, Nápoles AM, Piawah S, Santoyo-Olsson J, Teresi JA. Guidelines for evaluating the feasibility of recruitment in Pilot studies of diverse populations: an overlooked but important component. Ethn Dis. 2020;30(Suppl 2):745–54. https://doi.org/10.18865/ed.30.S2.745
Souffront K, Nelson B, Murphy M, Garay HR, Gordon L, Matos T et al. Stage B Heart Failure Is Ubiquitous in Emergency Patients with Asymptomatic Hypertension. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health [Internet]. 2024; https://escholarship.org/uc/item/0t02p5ch
Souffront K, Shubeck C, Nelson BP, Lukas M, Gordon L, Garay HR et al. Brief risk communication for sustained asymptomatic hypertension in the emergency department. J Emerg Nurs. [accepted August 13th, 2024]. Manuscript ID JEN-D-24-00176
EPIC Research. https://epicresearch.org/submission-guidelinesz . Accessed 8 May 2023.
Levy P, Ye H, Compton S, Zalenski R, Byrnes T, Flack JM, et al. Subclinical hypertensive heart disease in black patients with elevated blood pressure in an inner-city emergency department. Ann Emerg Med. 2012;60(4):467–e4741. https://doi.org/10.1016/j.annemergmed.2012.03.030
Patridge EF, Bardyn TP. Research Electronic Data Capture (REDCap). jmla [Internet]. 2018 Jan 12 [cited 2023 Oct 23];106(1). http://jmla.pitt.edu/ojs/jmla/article/view/319
Goldberg EM, Wilson T, Jambhekar B, Marks SJ, Boyajian M, Merchant RC. Emergency Department-provided home blood pressure devices can help detect undiagnosed hypertension. High Blood Press Cardiovasc Prev. 2019;26(1):45–53. https://doi.org/10.1007/s40292-019-00300-0
Meurer WJ, Dome M, Brown D, Delemos D, Oska S, Gorom V et al. Feasibility of Emergency Department–initiated, Mobile Health Blood Pressure Intervention: An Exploratory, Randomized Clinical Trial. Smith SW, editor. Academic Emergency Medicine [Internet]. 2019 May [cited 2023 Dec 6];26(5):517–27. https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1111/acem.13691
Skolarus LE, Dinh M, Kidwell KM, Lin CC, Buis LR, Brown DL et al. Reach Out Emergency Department: A Randomized Factorial Trial to Determine the Optimal Mobile Health Components to Reduce Blood Pressure. Circ: Cardiovascular Quality and Outcomes [Internet]. 2023 May [cited 2023 Dec 6];16(5). https://www.ahajournals.org/doi/ https://doi.org/10.1161/CIRCOUTCOMES.122.009606
Bennett GG, Steinberg D, Askew S, Levine E, Foley P, Batch BC, et al. Effectiveness of an app and provider counseling for obesity treatment in primary care. Am J Prev Med. 2018;55(6):777–86. https://doi.org/10.1016/j.amepre.2018.07.005
Lopes S, Mesquita-Bastos J, Garcia C, Bertoquini S, Ribau V, Teixeira M, et al. Effect of Exercise Training on ambulatory blood pressure among patients with resistant hypertension: a Randomized Clinical Trial. JAMA Cardiol. 2021;6(11):1317–23. https://doi.org/10.1001/jamacardio.2021.2735
Donini LM, Cuzzolaro M, Gnessi L, Lubrano C, Migliaccio S, Aversa A, et al. Obesity treatment: results after 4 years of a Nutritional and Psycho-Physical Rehabilitation Program in an outpatient setting. Eat Weight Disord. 2014;19(2):249–60. https://doi.org/10.1007/s40519-014-0107-6
Burchard EG, Oh SS, Foreman MG, Celedón JC. Moving toward True Inclusion of Racial/Ethnic Minorities in Federally Funded Studies. A Key Step for Achieving Respiratory Health Equality in the United States. Am J Respir Crit Care Med [Internet]. 2015 Mar 1 [cited 2023 Nov 15];191(5):514–21. https://www.atsjournals.org/doi/ https://doi.org/10.1164/rccm.201410-1944PP
Wright SW, Wrenn K. Funding in the emergency medicine literature: 1985 to 1992. Ann Emerg Med. 1994;23(5):1077–81. https://doi.org/10.1016/s0196-0644(94)70107-5
Singer AJ, Homan CS, Stark MJ, Werblud MC Jr., Hollander HCT. Comparison of types of Research Articles published in Emergency Medicine and Non-emergency Medicine journals. Acad Emerg Med. 1997;4(12):1153–8. https://doi.org/10.1111/j.1553-2712.1997.tb03699.x

Auteurs

Claire Shubeck (C)

Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA.

Hans Reyes Garay (H)

Department of Cardiology, Mount Sinai Morningside, 440 W 114th Street Suite 220, New York, NY, 10025, USA.

Bret P Nelson (BP)

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.

Marcee Wilder (M)

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.

Aleksandra Degtyar (A)

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.

Megan Lukas (M)

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.

Lauren Gordon (L)

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.

George T Loo (GT)

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.

Bernice Coleman (B)

Cedars-Sinai Medical Center, 8711 3rd Street, TSB, Room 1132, Los Angeles, CA, 90048, USA.

Lynne D Richardson (LD)

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, 1468 Madison Ave 11th Floor, New York, NY, 10029, USA.

Kimberly Souffront (K)

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA. kimberly.souffront@mountsinai.org.
Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA. kimberly.souffront@mountsinai.org.
Center for Nursing Research and Innovation, Mount Sinai Health System, 1 Gustave L. Levy Place, New York, NY, 10029, USA. kimberly.souffront@mountsinai.org.

Classifications MeSH