2025/09/22 by Ellen K. Murphy, Sharon McCann, Frances Shiely +1 · 1 voice
Medicine · Mathematics · Decision Sciences · #Ethics in Clinical Research #Statistical Methods in Clinical Trials #Meta-analysis and systematic reviews
paper · pdf · doi:10.1016/j.jclinepi.2025.111979
openalex publication_date 2025/09/22 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/22
OBJECTIVES: To address poor participant retention, trial teams often use retention strategies. Evidence on the planning of retention strategies in trials is limited. Based on our previously conducted research, and other existing literature, it is unclear whether retention strategies are prospectively or retrospectively planned by trialists. Our objective was to investigate this. STUDY DESIGN AND SETTING: One-to-one semistructured interviews, online or in person, were conducted with trialists in the United Kingdom and Ireland to gain better insights into planning retention strategies across various trialists viewpoints. Purposive snowball sampling was used to recruit interviewees. Data were analyzed using framework analysis. This approach was chosen to aid in identifying similarities and differences in patterns in the data within and between different groups of trialists interviewed, for example, Trial Managers, Research Nurses, Principal Investigators etc. RESULTS: Twenty-four trialists were interviewed, including trial managers, study co-ordinators, principal investigators, research nurses, a head of trial operations, a clinical trial unit director, a clinical trial monitor, a co-investigator, and a clinical trials practitioner. Findings show that the development of retention strategies in trials is mostly done proactively during the design and planning stages of the trial, that is, during trial design and protocol development. Participant retention, however, is an ongoing process, and if retention rates are problematic, additional strategies are reactively planned and implemented. Strategies tend to be chosen by the core trial management team, and the choice of strategy is mainly guided by prior experience. A variety of different formal strategies (explicitly and intentionally planned strategies that are often more structured, such as reminders or incentives) are used to facilitate ongoing participant retention. Informal strategies (not explicitly or intentionally planned), such as building rapport with participants and having motivated and invested trial staff, are also highlighted as being important to facilitating retention in trials. CONCLUSION: Most trialists proactively plan and implement retention strategies during the design and planning stages of the trial but are also responsive to poor retention rates as the trial is ongoing. Currently, retention strategies are chosen based on prior experience of using the strategy. More formal evaluation of effectiveness is needed to help facilitate evidence-based decision-making when choosing retention strategies.