Table 4 Suggested actions to assist patient recruitment into a lung diagnosis trial

Practice ‘motivators’ to join the trial as recruiters

• The benefits to practice participation should be highlighted to practices. These can include financial reimbursement, CPD points or certificates for staff, gaining practice research accreditation status and clinical and research learning opportunities for staff

• Initial discussions should focus on the practice’s clinical and research interests to determine practice focus

• The numbers of required eligible patients registered at a Practice should be explored to scope for recruitment ability

• The benefits to patients should be highlighted

Health professional interactions with patients

The challenges of identifying and recruiting eligible patients

• Frequent discussions with recruiting staff should be employed at outset of study to feedback any problems

• The benefits of research nurses to specifically recruit participants should be highlighted along with the possibility of them being financed by government bodies

• Trial practice training days should offer evidence based information on the safety of chest X-rays

• Trial practice training days should determine staff understanding of recruitment documentation

Presenting the trial to patients

• Advise staff on the use of non-anxiety invoking language with participants when discussing lung diagnosis

Completion of patient questionnaires

• Trial practice training days should check staff satisfaction with trial documentation

• Practice staff should determine the staff member(s) who are best able to help populate participant documentation

Explaining chest X-ray referrals to patients

• Staff should focus on trial equipoise when discussing trial arms with patients

• Advise practice staff that a small amount of patients may feel anxious when waiting for chest X-ray results

Practice organisation to undertake trial

• Encourage practice to choose one staff member who will be accountable for the trial

• Advise practice staff of the efficacy of using only permanently employed staff where possible to better ensure continuity

• Discuss with practice the possibility of using Government funded research nurses to engage with study documentation

• Assist staff to have a clear recruitment plan before commencing trial

Researcher team support and involvement

• Research team to ensure frequent contact with practice staff at start and during the course of the study to determine the occurrence of any problems. Embedded qualitative research interviews with staff may highlight any challenges.

• Research team to send regular newsletters to staff to ensure their continued focus on trial.

• Great emphasis needs to be placed on practice training day to allow for discussion and questions.

• Ensure practice staff (including non-clinical staff) are consulted on trial design and delivery before start of trial

• Suggest to practices the possibility of engaging with a research practice mentor, one who has experience in participating in trials.