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Optimised clinical study recruitment in palliative care: success strategies and lessons learned
  1. Clare White1,
  2. Simon Noble2,
  3. Max Watson3,
  4. Flavia Swan4,
  5. Annmarie Nelson2 and
  6. Miriam J Johnson4
  1. 1 Northern Ireland Hospice, Belfast, UK
  2. 2 Marie Curie Palliative Care Research Centre, Cardiff University, Cardiff, UK
  3. 3 Hospice UK, London, UK
  4. 4 Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hul, Hull, UK
  1. Correspondence to Dr Clare White, Adult Services, Northern Ireland Hospice, Belfast BT15 3LH, UK; cwhite{at}


Recruitment challenges to clinical research studies in palliative care settings, particularly in hospices, are well documented. However, a recent study (Hospice Inpatient Deep vein thrombosis Detection (HIDDen) study) performed across five hospices in the UK recruited above target and on time. We describe strategies that aided successful recruitment in this study, and the lessons learnt for improving future studies. A recent review suggested that the ‘Social Marketing Mix Framework’ (SMMF) could help researchers with recruitment strategies in palliative care. We describe the recruiting strategies employed through the Social Marketing Mix lens and consider if it would be a useful framework for future researchers to use at the planning stage. Successful recruitment strategies employed in HIDDen study included: (i) addressing particular study-related factors, (ii) ensuring all patients were screened and offered participation if eligible, (iii) reducing impact on the clinical team through dedicated research nurses at sites, (iv) addressing research team issues with cross-cover between sites, where geographically possible, and (v) regular video conferencing meetings for support and collaborative solving of challenges. Limited pre-existing research infrastructure at most of the recruiting hospices created particular challenges. The SMMF provides a potential structure to help researchers to plan recruitment. However, to fully streamline trial set up and in order for hospice involvement in research to be realised systematically, a centralised approach to governance, organisational culture change whereby hospices embrace research as a legitimate purpose and consistent access to research staff are identified as key strategic elements promoting recruitment to studies in hospices.

  • palliative
  • recruitment
  • hospice
  • Social Marketing Mix Framework
  • clinical study

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  • Contributors Concept: SN, CW, MJJ and MW. First draft of the manuscript: CW. Critical revision of the manuscript: CW, SN, MJJ, MW, AN and FS. Contribution to and approval of the final manuscript: all authors.

  • Funding The HIDDen study was funded by the NIHR Research for Patient Benefit programme (PB-PG-0614-34007). There was no additional funding for this publication. SN and AN’s posts are funded by Marie Curie Cancer Care core grant funding (grant reference: MCCC-FCO-17-C).

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funder had no role in the study design, data collection, data analysis, data interpretation or writing of the report. The corresponding author had full access to all the data used in the study and has final responsibility for the decision to submit for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Yorkshire & the Humber—Leeds West Research Ethics Committee; 16/YH/0045.

  • Provenance and peer review Not commissioned; externally peer reviewed.