Recruitment to personality disorder treatment trials

Randomised controlled trial (RCT) methodology is viewed as the gold standard in evaluating the impact of interventions. Recruitment problems present one threat to the validity of RCTs, yet the barriers to recruitment are poorly understood. The purpose of this study is to identify obstacles to recruitment in a personality disorder (PD) treatment trial, with a view to suggesting ways of overcoming these obstacles.

A discussion group of 13 staff involved in the trial was held to identify barriers to recruitment. The information was subject to thematic analysis.

Eight themes were identified, and three overarching themes: reluctance to diagnose and preference for treating symptoms; increasing the burden and jeopardising other services; and lack of confidence in treatment and in treatment as usual.

Suggestions for minimising recruitment obstacles include careful site selection and protocol negotiation; education and training about PD; continued promotion of both research in general and the specific trial; and assurances about good research practice.

Recruitment is a common problem in RCTs, and the paper addresses this issue, not only in identifying obstacles to recruitment but also in offering suggestions to other trialists for minimising the obstacles.