MP636UNDERSTANDING PATIENTS' PERSPECTIVES INFLUENCING PARTICIPATION WITHIN EQUAL STUDY IN UK- A QUALITATIVE STUDY

Abstract

Introduction and Aims: European Quality (EQUAL) Study is a multinational and multicentre study on treatment in advanced chronic kidney disease (CKD) with the United Kingdom (UK) one of the participant countries. Recruitment into studies can often be problematic with older frailer patients and those with multiple co-morbidities less likely to agree to participate in studies. Non-participation can not only affect a studies internal validity but also its external validity (generalizability). A qualitative study was embedded within the EQUAL study in the UK with an aim to understand issues those underpin patient recruitment. Methods: The qualitative interviews were based on the validated QRI (Quintet Recruitment Intervention) methodology which was designed by researchers at the School of Social and Community Medicine, University of Bristol. The sites for the patient interviews were 3 of the 10 EQUAL recruitment sites in the UK (Bristol, Salford {&} Oxford) which were selected according to recruitment data from the first few months of the study. Patients were sampled for the one on one interview both in the agreed to participate and declined to participate groups with purposive sampling used to achieve maximum variation in terms of age (65-74 {&} 75 above) and comorbidity (0-2 {&} ≥3). A topic guide was used to ensure consistency with participants encouraged to raise the issues they consider important. Interviews were audio recorded and transcribed verbatim with participants' consent. NVivo software was used to aid analysis. Results: There were seventeen interviews each conducted in the group that agreed and in the group that declined to participate in order to achieve saturation. These interviews yielded over 3000 references which were grouped under eight main themes encompassing over 100 sub-themes. Under the broad umbrella of “Trust”, important sub-themes included were source of contact, out of blue, family and comfort zone. “Study related” was the overarching theme relating to patient understanding of why they were chosen, reason for the study, preferred manner of approach, information quality and clarity. “Personal and beliefs” was the main theme exploring patient's perceptions to their health and healthcare, life experiences and also family and friend's health experiences influencing patient participation. Under the general theme of “Medical Research” patient's perceptions to medical research, previous experiences of research and patient's insight of importance of medical research were grouped. Importance of patient activation and how functional status and health problems affect patient participation was grouped under “Health”. The theme “Decision making” included sub-themes such as worthwhile and personal gain, timing of approach and study burden. Transportation, support system and mobility were some of the sub-themes grouped under “Convenience”. The theme of “Altruism” explored patient attitudes of reasons for participation. Conclusions: These initial themes will be analysed further using the method of constant comparison with data relating to each theme {&} sub-theme examined closely for content. This will then be compared within and across individuals or groups to identify important similarities and differences and to establish interpretive categories.