Services and patients lack high quality evidence of effectiveness of speech and language therapy intervention for people with Parkinson’s disease. The PD COMM trial is designed to provide best evidence around effectiveness, cost-effectiveness and implementation of Lee Silverman Voice Treatment and other standard NHS intervention tailored to clients’ individual needs. Recruiting the 546 participants depends first on engaging over 40 speech and language therapy departments across the UK as enthusiastic clinical collaborators. By reporting on this work-in-progress in relation to Scotland, we hope to encourage speech and language therapists to reflect on the wider implications of becoming involved (or not) with large-scale research studies.
Speech and language therapists’ key role in the trial is to offer the two interventions to randomised patients, and to complete study paperwork and interviews about their intervention. The opportunity to participate in this type of study is rare. PD COMM is a large pragmatic UK randomised controlled trial with an integral process evaluation, funded by the National Institute for Health Research Health Technology Assessment Programme. People with Parkinson’s disease were involved in the design, it was based on a successful pilot (Sackley et al., submitted), and benefits for therapists include free training and supported continuing professional development. However, departments have many demands on their time, and we cannot take for granted that therapists will consider participating in a randomised controlled trial to be in the best interests of their patients, themselves, their departments, or their profession.
A quarter of randomised controlled trials are stopped due to poor recruitment. While there is a growing body of research evidence around improving recruitment of patients, there is little to support decision-making for engaging departments who will provide the therapy interventions. A systematic review of the reasons for poor recruitment in discontinued trials suggested most were preventable (Briel et al., 2016). Among these was prejudice against effectiveness of the trial interventions, including concerns around equipoise, professional autonomy, representation of current practice, and impact on patients and professional-patient relationships.
This poster outlines how we have used evidence from the literature, previous experience, and feedback from the therapists we approached to develop and refine a responsive strategy for engaging speech and language therapy departments in Scotland in the PD COMM trial. It will also include the most up-to-date information on PD COMM recruitment.