Importance of primary care leadership involvement: recruitment lessons from an office-based urinary incontinence intervention

You have accessJournal of UrologyCME1 Apr 2023MP72-06 IMPORTANCE OF PRIMARY CARE LEADERSHIP INVOLVEMENT: RECRUITMENT LESSONS FROM AN OFFICE-BASED URINARY INCONTINENCE INTERVENTION Kyle Okamuro, Catherine Bresee, Isabella Dolendo, Karyn Eilber, Ramy Eskander, Tamara Grisales, Jejo Koola, Allison Mays, Carmen Mendez, Marlene Millen, Teryl Nuckols, Joshua Pevnick, David Reuben, Jennifer Singer, Ming Tai-Seale, Florin Vaida, Katherine Ward, Neil Wenger, Tajnoos Yazdany, Xi Zhu, and Jennifer Anger Kyle OkamuroKyle Okamuro More articles by this author , Catherine BreseeCatherine Bresee More articles by this author , Isabella DolendoIsabella Dolendo More articles by this author , Karyn EilberKaryn Eilber More articles by this author , Ramy EskanderRamy Eskander More articles by this author , Tamara GrisalesTamara Grisales More articles by this author , Jejo KoolaJejo Koola More articles by this author , Allison MaysAllison Mays More articles by this author , Carmen MendezCarmen Mendez More articles by this author , Marlene MillenMarlene Millen More articles by this author , Teryl NuckolsTeryl Nuckols More articles by this author , Joshua PevnickJoshua Pevnick More articles by this author , David ReubenDavid Reuben More articles by this author , Jennifer SingerJennifer Singer More articles by this author , Ming Tai-SealeMing Tai-Seale More articles by this author , Florin VaidaFlorin Vaida More articles by this author , Katherine WardKatherine Ward More articles by this author , Neil WengerNeil Wenger More articles by this author , Tajnoos YazdanyTajnoos Yazdany More articles by this author , Xi ZhuXi Zhu More articles by this author , and Jennifer AngerJennifer Anger More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003340.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Low rates of recruitment pose significant barriers to the success of trials and can lead to incomplete trials, insufficient power, and inconclusive results. There is limited literature on strategies to recruit providers for studies evaluating practice-based interventions. We sought to identify barriers to recruitment of primary care (PC) providers and improve enrollment for an office-based urinary incontinence (UI) intervention. METHODS: The intervention consists of a combination of academic detailing, clinical decision support, co-management with a dedicated advanced practice provider, and implementation of an e-consult referral service, in which referrals lacking appropriate primary UI care are returned. The recruitment goal of the study is to enroll 225 providers, across 60 primary care offices within 4 Southern California medical groups. Recruitment barriers were identified based on clinician and PC leadership feedback. RESULTS: Between February and October 2022, meetings were held between study investigators and PC leadership at each site to identify eligible PC offices. Offices were excluded for intrinsic and extrinsic factors incompatible with the study design including lack of integration with the electronic medical record environment and transitioning clinical leadership. Eligible offices were contacted and asked to participate. Providers cited time constraints, prioritization of other medical issues during the visit, discomfort providing UI counsel or initiating UI medications, and concerns of increased clinic burden as barriers to enrollment. Strategies that improved provider buy-in included PC leadership emphasizing the implementation of Medicare 5 Star metrics for UI as the future of standard clinical care, investigators integrating provider feedback into the design of the intervention, and emphasizing study interventions that could reduce clinical burden. With these strategies, 61 offices across the 4 sites agreed to participate. CONCLUSIONS: Lower than expected recruitment rates threaten the success of a clinical trial. Early identification of potential barriers and involvement of PC leadership in intervention design and office selection can improve recruitment rates and lead to high-quality practice-based intervention trials. Source of Funding: Funded by the Agency of Healthcare Research and Quality. Project 1U18HS028740 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1026 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyle Okamuro More articles by this author Catherine Bresee More articles by this author Isabella Dolendo More articles by this author Karyn Eilber More articles by this author Ramy Eskander More articles by this author Tamara Grisales More articles by this author Jejo Koola More articles by this author Allison Mays More articles by this author Carmen Mendez More articles by this author Marlene Millen More articles by this author Teryl Nuckols More articles by this author Joshua Pevnick More articles by this author David Reuben More articles by this author Jennifer Singer More articles by this author Ming Tai-Seale More articles by this author Florin Vaida More articles by this author Katherine Ward More articles by this author Neil Wenger More articles by this author Tajnoos Yazdany More articles by this author Xi Zhu More articles by this author Jennifer Anger More articles by this author Expand All Advertisement PDF downloadLoading ...