Table 1.
Facilitators and barriers for conducting cross-national GR research.
| Facilitators | Barriers |
|---|---|
| Recruitment of GR centres | |
| Using regional, national, and international GR networks to promote study participation | Lack of tight regional and/or national GR networks |
| Choosing a research topic that is of interest to researchers in multiple countries | Heterogeneity in care setting and practice |
| Publishing protocol paper | Heterogeneity in eligible patients for GR |
| Appointing national coordinators who have a strong national network in GR and knowledge of national ethical regulations | Heterogeneity of legislation and procedures relating to ethical approval |
| Physical kick-off meeting for all national coordinators | |
| Posting recruitment calls on social media | |
| Transparency about co-authorship and data sharing policies | |
| Financial resources to conduct the study | |
| Inclusion of GR patients | |
| Appointing local coordinators to coordinate and promote the study within their centre | Main reason for referral can be ambiguous for multimorbid patients |
| Start-up videocalls with local coordinators | Patients may speak different languages |
| Regular (e.g., monthly) videocalls with national and local coordinators during inclusion period | Absence of back-up representatives for the local coordinators |
| Well-illustrated patient information sheet, i.e., comprehensible for older people | |
| Financial recourses for translation of consent forms and patient information sheets to local lay terms and minority languages | |
| Data collection | |
| Using regular care data from EHR 1, i.e., no additional measurements needed | Regular care data differs between countries, i.e., lack of core dataset |
| Standard Operation Procedures (SOPs) including step-by-step instructions for data collection | Heterogeneity in EHR 1 systems preventing automated data extraction |
| GDPR 2/HIPAA 3 compliant data capturing system | Lack of sensitive/specific cross-culturally validated questionnaires for GR |
| Drafting and regularly updating a data management plan and a metadata file. | |
1 EHR = electronic health records; 2 GDPR = General Data Protection Regulation (EU); 3 HIPAA = Health Insurance Portability and Accountability Act (US).