Recruiting for a pragmatic trial using the electronic health record and patient portal: successes and lessons learned. (16th November 2018)

• Record Type: Journal Article
• Authors: Pfaff, Emily; Lee, Adam; Bradford, Robert; Pae, Jinhee; Potter, Clarence; Blue, Paul; Knoepp, Patricia; Thompson, Kristie; Roumie, Christianne L; Crenshaw, David; Servis, Remy; DeWalt, Darren A
• Is Part Of: Journal of the American Medical Informatics Association. Volume 26:Number 1(2019)
• Page Start: 44
• Page End: 49
• Publication Date: 2018-11-16
• Subjects: electronic health records -- pragmatic clinical trials -- research subject recruitment -- patient portals; Medical informatics -- Periodicals; Information Services -- Periodicals; Medical Informatics -- Periodicals; Médecine -- Informatique -- Périodiques; Informatica; Geneeskunde; Informatique médicale; Computer network resources; Electronic journals; 610.285
• DOI: 10.1093/jamia/ocy138
• Languages: English
• ISSNs: 1067-5027

Abstract

Abstract: Objective: Querying electronic health records (EHRs) to find patients meeting study criteria is an efficient method of identifying potential study participants. We aimed to measure the effectiveness of EHR-driven recruitment in the context of ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness)—a pragmatic trial aiming to recruit 15 000 patients. Materials and Methods: We compared the participant yield of 4 recruitment methods: in-clinic recruitment by a research coordinator, letters, direct email, and patient portal messages. Taken together, the latter 2 methods comprised our EHR-driven electronic recruitment workflow. Results: The electronic recruitment workflow sent electronic messages to 12 254 recipients; 13.5% of these recipients visited the study website, and 4.2% enrolled in the study. Letters were sent to 427 recipients; 5.6% visited the study website, and 3.3% enrolled in the study. Coordinators recruited 339 participants in clinic; 23.6% visited the study website, and 16.8% enrolled in the study. Five-hundred-nine of the 580 UNC enrollees (87.8%) were recruited using an electronic method. Discussion: Electronic recruitment reached a wide net of patients, recruited many participants to the study, and resulted in a workflow that can be reused for future studies. In-clinic recruitment saw the highest yield, suggesting that a combination of recruitment methods may be the best approach. Future work should account for demographic skew that may result by recruiting from a pool of patient portal users. Conclusion: The success of electronic recruitment for ADAPTABLE makes this workflow well worth incorporating into an overall recruitment strategy, particularly for a pragmatic trial.