Barriers to Participation in a Randomized Controlled Trial of Qigong Exercises Amongst Cancer Survivors: Lessons Learnt

  • Loh, Siew Yim (Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya) ;
  • Lee, Shing Yee (Institute of Postgraduate Studies, University of Malaya) ;
  • Quek, Kia Fatt (School of Medicine and Health, Sunway Campus Monash University) ;
  • Murray, Liam (School of Public Health, Queens University)
  • Published : 2012.12.31


Background: Clinical trials on cancer subjects have one of the highest dropout rates. Barriers to recruitment range from patient-related, through institutional-related to staff-related factors. This paper highlights the low response rate and the recruitment barriers faced in our Qigong exercises trial. Materials and Method: The Qigong trial is a three-arm trial with a priori power size of 114 patients for 80% power. The University Malaya Medical Centre database showed a total of 1,933 patients from 2006-2010 and 751 patients met our inclusion criteria. These patients were approached via telephone interview. 131 out of 197 patients attended the trial and the final response rate was 48% (n=95/197). Results: Multiple barriers were identified, and were regrouped as patient-related, clinician-related and/or institutional related. A major consistent barrier was logistic difficulty related to transportation and car parking at the Medical Centre. Conclusions: All clinical trials must pay considerable attention to the recruitment process and it should even be piloted to identify potential barriers and facilitators to reduce attrition rate in trials.


Randomized controlled trials;barriers;retention;recruitment exercise;qigong;complex interventions


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