Barriers to patient recruitment in a poststroke neurorehabilitation multicenter trial in Brazil

Author(s):Show less -

da Silva, T. R. ; Luvizutto, G. J. ; Martins, L. G. ; da Costa, R. D. M. ; de Souza, J. T. ; Winckler, F. C. ; Sartor, L. C. A. ; Modolo, G. P. ; Ferreira, N. C. ; Rodrigues, J. C. S. ; Kanda, R. G. ; Fogaroli, M. O. ; Borges, G. F. ; Rizzatti, G. R. S. ; Ribeiro, P. W. ; Pires, D. S. ; Favoretto, D. B. ; Aguiar, L. R. ; Bazan, S. G. Z. ; Betting, L. E. G. ; Antunes, L. C. O. ; Nunes, H. R. C. ; Pereira, V. M. ; Edward, T. G. S. ; Pontes-Neto, O. ; Conforto, A. B. ; Bazan, R.

• Document type: Journal article
• Source: Brazilian Journal of Medical and Biological Research; v. 56, p. 8-pg., 2023-01-01.

Abstract

There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke. (AU)

• FAPESP's process: 15/14231-0 - Effects of the transcranial electric estimulation on the unilateral spatial neglect syndrome after stroke.
• Grantee: Rodrigo Bazan
• Support Opportunities: Regular Research Grants