Table 4.
Recruitment barriers and enablers reported by GPs in free text boxes
| Theme | Example |
|---|---|
| Patient level barriers (perceived by GP) | |
| Patient unwilling to participate | “Patients who were well controlled on [Diskus] and Turbuhalers were very reluctant to change over to Seretide [Advair] MDI and about 3 patients refused to enter study for this reason.” |
| Patients unavailable to participate | “Some patients were geographically unavailable: [they worked as fly-in-fly-out employees in mines in Western Australia], some changed address.” |
| GP level recruitment barriers | |
| Few eligible patients perceived by GP | “I don't think you could have done any more. I guess most of my patients have well-controlled asthma!” |
| Difficulty prioritizing research due to perceived demands of study or time constraints | “You did a lot to assist recruitment. The excessive amounts of work involved put us off the desire. We then did not give much effort.” |
| Confusion about recruitment information | “When invited to participate I agreed because I had patients on Symbicort and Seretide. Unfortunately by the time I entered the study only Seretide was an option. I was not prepared to swap patients off Symbicort (my drug of choice).”* |
| Study thought to be too intellectual or confronting for patients | “I feel your program is too intellectual for ordinary patients who find instructions too difficult and give up & avoid anything too confronting and being shown up by other parties is unhelpful.” |
| Confusion around disease diagnosis and management | “Asthma/COAD i.e. Patient was diagnosed with asthma in the past and later diagnosed with COAD by specialist.” |
| Practice/organization level barriers | |
| GP not empowered to recruit within a group practice | “I had a poster in my [office], this did result in some patients volunteering when they read [the] notice (our waiting room is very large and we are prohibited to putting up such posters).” |
| “As I am a new GP here I could not/did not try to recruit other doctor's patients into the study. I did not want to take other doctors patients unless they spontaneously moved to see me”. | |
| Study level barriers | |
| Need for more recruitment support | “If a personnel from MICA was sent to help with recruitment that will be a great help for us or for future sites.” |
| Study materials needed in languages other than English | “I have a lot of patients with limited English, explanation (how to use spacer etc.) in [a language] other than English will help for some.” |
| Lack of incentive for patient | “It was very hard to convince the patients to participate. [There was] not much incentive.” |
| GP level recruitment enablers | |
| Good recruitment support | “No! The support and induction processes were excellent.” |
| Study perceived as beneficial to GPs practice | “MICA study was beneficial personally in learning some new techniques and also had satisfaction [in] that it helped my patients in many ways to improve control and understand their condition.” |
*Note - there was no change in the inclusion criteria; the need to switch patients taking another medication at entry was clearly stated during the workshop and in the study materials.