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Who does not participate in telehealth trials and why? A cross-sectional survey

Foster, Alexis; Horspool, Kimberley; Edwards, Louisa; Thomas, Clare; Salisbury, Chris; Montgomery, Alan A.; O'Cathain, Alicia

Authors

Alexis Foster

Kimberley Horspool

Louisa Edwards

Clare Thomas

Chris Salisbury

Alan A. Montgomery

Alicia O'Cathain



Abstract

Background
Telehealth interventions use information and communication technology to provide clinical support. Some randomised controlled trials of telehealth report high patient decline rates. A large study was undertaken to determine which patients decline to participate in telehealth trials and their reasons for doing so.

Methods
Two linked randomised controlled trials were undertaken, one for patients with depression and one for patients with raised cardiovascular disease risk (the Healthlines Study). The trials compared usual care with additional support delivered by the telephone and internet. Patients were recruited via their general practice and could return a form about why they were not participating.

Results
Of the patients invited, 82.9 % (20,021/24,152) did not accept the study invite, either by returning a decline form (n = 7134) or by not responding (n = 12,887). In both trials patients registered at deprived general practices were less likely to accept the study invite. Decline forms were received from 29.5 % (7134/24,152) of patients invited. There were four frequently reported types of reasons for declining. The most common was telehealth-related: 54.7 % (3889/,7115) of decliners said they did not have access or the skills to use the internet and/or computers. This was more prevalent amongst older patients and patients registered at deprived general practices. The second was health need-related: 40.1 % (n = 2852) of decliners reported that they did not need additional support for their health condition. The third was related to life circumstances: 27.2 % (n = 1932) of decliners reported being too busy. The fourth was research-related: 15.3 % (n = 1092) of decliners were not interested in the research.

Conclusions
A large proportion of patients declining participation in these telehealth trials did so because they were unable to engage with telehealth or did not perceive a need for it. This has implications for engagement with telehealth in routine practice, as well as for trials, with a need to offer technological support to increase patients’ engagement with telehealth. More generally, triallists should assess why people decline to participate in their studies.

Journal Article Type Article
Publication Date Jun 5, 2015
Journal Trials
Electronic ISSN 1745-6215
Publisher Springer Verlag
Peer Reviewed Not Peer Reviewed
Volume 16
Issue 258
APA6 Citation Foster, A., Horspool, K., Edwards, L., Thomas, C., Salisbury, C., Montgomery, A. A., & O'Cathain, A. (2015). Who does not participate in telehealth trials and why? A cross-sectional survey. Trials, 16(258), https://doi.org/10.1186/s13063-015-0773-3
DOI https://doi.org/10.1186/s13063-015-0773-3.
Keywords Telehealth – Trials – Declines – Recruitment – Non-participation – Refusers
Publisher URL https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-015-0773-3
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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