Influence of clinician characteristics and operational factors on recruitment of participants with low back pain: an observational study

Daniel Steffens; Chris G Maher; Manuela L Ferreira; Mark J Hancock; Leani S M Pereira; Christopher M Williams; Jane Latimer

doi:10.1016/j.jmpt.2014.10.016

Influence of clinician characteristics and operational factors on recruitment of participants with low back pain: an observational study

J Manipulative Physiol Ther. 2015 Feb;38(2):151-8. doi: 10.1016/j.jmpt.2014.10.016. Epub 2015 Jan 15.

Authors

Daniel Steffens¹, Chris G Maher², Manuela L Ferreira³, Mark J Hancock⁴, Leani S M Pereira⁵, Christopher M Williams⁶, Jane Latimer²

Affiliations

¹ PhD Student, Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia; PhD Student, Department of Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, Brazil. Electronic address: dsteffens@georgeinstitute.org.au.
² Professor, Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
³ Senior Research Fellow, Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
⁴ Senior Lecturer, Discipline of Physiotherapy, Faculty of Human Sciences, Macquarie University, Sydney, Australia.
⁵ Professor, Department of Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
⁶ Research Fellow, Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.

PMID: 25600119
DOI: 10.1016/j.jmpt.2014.10.016

Abstract

Objective: The purpose of this study was to identify factors that influence recruitment of patients to an observational study of low back pain (LBP).

Methods: From 1147 primary care (first health contact) clinicians initially contacted, 138 (physiotherapists and chiropractors) agreed to participate in a large observational study of LBP and were the focus of the current study. Data were collected pertaining to clinicians' characteristics, operational factors, and the number of patients recruited. The association of a variety of clinician characteristics and operational factors with recruitment rate was determined using a multivariate negative binomial regression analysis.

Results: From October 2011 to November 2012, 1585 patients were screened by 138 study clinicians with 951 eligible patients entering the observational study. Clinicians who were members of their professional association had a recruitment rate less than half that of those who were nonmembers (P < .0001). Clinicians who were trained by telephone had a recruitment rate 4.01 times higher than those trained face to face (P < .0001). Similarly, clinicians who referred a larger number of ineligible participants had a slightly higher recruitment rate with an incident rate ratio of 1.04 per ineligible patient (P < .0001). Other clinicians' characteristics and operational factors were not associated with recruitment.

Conclusion: This study provides evidence that it is feasible to recruit participants from primary care practices to a simple observational study of LBP. Factors identified as influencing recruitment were professional association (negative association), training by telephone, and referring a higher number of ineligible participants.

Keywords: Back Pain; Chiropractic; Patient Selection; Physical Therapy; Primary Health Care.

Publication types

Observational Study

MeSH terms

Adult
Female
Humans
Low Back Pain / diagnosis*
Low Back Pain / rehabilitation*
Male
Manipulation, Chiropractic / methods*
Manipulation, Spinal / methods
Middle Aged
Multivariate Analysis
Pain Measurement
Patient Selection
Practice Patterns, Physicians'*
Primary Health Care / methods
Regression Analysis
Severity of Illness Index
Treatment Outcome