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From Planning to Implementation: The Challenges of Recruiting Older Adults With Parkinson’s to a Feasibility Trial

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By: & Edited by: Published: 2020 | Product: SAGE Research Methods Cases: Medicine and Health
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Abstract

MeMory PaD was a 24-month feasibility trial of two slow-release dopamine agonists, pramipexole, and ropinirole, prescribed in Parkinson’s to manage movement problems. MeMory PaD opened in April 2013 and closed in September 2015. A total of 220 patients were pre-screened for eligibility, and 145 were excluded because they were not already on either pramipexole or ropinirole, their dopamine agonist dose was too high, they had a co-morbid neurological condition, or they were over 80 years of age. Seventy-five patients were invited to participate. Enrollment was low, with 53 people with Parkinson’s declining our invitation. This is unsurprising, since we were asking patients to change their Parkinson’s medication and to undergo periods of medication withdrawal. Nevertheless, 22 people with Parkinson’s agreed to take part, and 14 completed the study. The low recruitment rate reflects, in part, concerns about switching dopamine agonists and the risk this has for experiencing side-effects and a worsening of Parkinson’s, too many appointments and difficulty getting to the research centers because of mobility problems, the research process and not knowing the researchers, and increasing the workload for carers or family members. Nine participants experienced adverse events and were either withdrawn or were swapped back to their original dopamine agonist, but stayed in the study. This allowed us to test the clinical support for participants with adverse events present. Different methods of recruiting participants have also been explored. These include raising awareness with promotional material in local newspapers and pharmacies, and forming links with other recruitment sites such as general practitioner surgeries.

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