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

Background: Clinical trials on cancer subjects have one of the highest dropout rates. Barriers to recruitmentrange from patient-related, through institutional-related to staff-related factors. This paper highlights the lowresponse rate and the recruitment barriers faced in our Qigong exercises trial. Materials and
Method: The Qigongtrial is a three-arm trial with a priori power size of 114 patients for 80% power. The University Malaya MedicalCentre 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 finalresponse rate was 48% (n=95/197).
Results: Multiple barriers were identified, and were regrouped as patientrelated,clinician-related and/or institutional related. A major consistent barrier was logistic difficulty relatedto transportation and car parking at the Medical Centre.
Conclusions: All clinical trials must pay considerableattention to the recruitment process and it should even be piloted to identify potential barriers and facilitatorsto reduce attrition rate in trials.