This is an edited extract taken from a longer article published in ‘Progress in Neurology and Psychiatry‘.
‘Research is critical in advancing health care and improving outcomes for patients. The NHS constitution pledges to inform patients of research that they may be eligible to participate in. However, this often does not occur and can be particularly challenging in mental health services, with a number of barriers causing difficulties. Here the authors explore some of the reasons for difficulties in recruiting patients to mental health studies and offer a potential solution.
Mental health studies often recruit low numbers of participants: in one evaluation fewer than a third achieved their recruitment targets on time. This is an economic and ethical issue, with ‘failed’ studies incurring significant financial costs and not gathering evidence despite patients giving their time and taking part. The reasons for this problem are complex.’
In Oxford Health Foundation Trust (OHFT) we decided that it was clearly in the best interests of patients, clinical staff, and research teams that something be done to remedy this situation and bring clinical care and research closer together. A pilot with research assistants (RAs) working 50% in research and 50% in clinical practice had previously been successful and the trust’s management agreed to extend this by joint funding seven RA posts with the National Institute for Health Research (NIHR) Clinical Research Network for the Thames Valley and South Midlands. The specific remit of the RAs was to embed themselves within clinical teams. This turned on its head the traditional approach of the research team being located on another site and visiting.
By being visible within teams and available to help with clinical work we aimed to:
- Increase awareness of research in general, and of specific studies that were available for patients
- Reassure clinical teams by repeated demonstration that research does not harm patients and, indeed, is associated with improved outcome
- Make research teams and staff more aware and considerate of the pressures in clinical services
- Get closer to the point where it is patients themselves who decide whether or not to take part in research
- Allow for the adoption of studies that address the whole spectrum of mental health and ensure that study adoption was sensitive to the needs of the clinical service to reduce tensions in provision and research.
From our pilot it was also clear that a large number of patients received interventions and support that they otherwise would not have done and that the researchers themselves very much valued the clinical practice and extra experience. The latter made posts attractive and enabled a number of people to move on into clinical training posts.’
To read the full article see Progress in Neurology and Psychiatry.