Optimising ambulance service contribution to clinical trials: a phenomenological exploration using focus groups

Area of Science:

• Emergency medicine
• Clinical trial methodology
• Paramedic practice

Background:

• Out-of-hospital cardiac arrest (OHCA) trials present recruitment challenges.
• The PARAMEDIC2 trial investigated adrenaline's efficacy in OHCA using a placebo-controlled design.
• This study aimed to capture the experiences of ambulance staff involved in the PARAMEDIC2 trial.

Purpose of the Study:

• To describe the operational experiences of ambulance staff during the PARAMEDIC2 trial.
• To identify facilitators and barriers to recruitment in pre-hospital cardiac arrest research.
• To inform future trial design and implementation in emergency settings.

Main Methods:

• Four focus groups were conducted with trial paramedics and emergency care staff.
• Participants were drawn from a single UK ambulance service involved in the PARAMEDIC2 study.
• Thematic analysis, supported by NVivo 12, was used to identify key themes.

Main Results:

• Forty-four participants shared experiences, highlighting four themes: research context, ethical concerns, patient-side issues, and trial support.
• Paramedics recognized the importance of research but faced ethical dilemmas, particularly regarding consent and patient outcomes.
• Simplicity in trial processes, effective training, and personalized feedback were crucial for successful recruitment and performance.

Conclusions:

• Paramedic engagement and performance in large-scale pre-hospital trials are influenced by their experiences.
• Investing in face-to-face training and individualized feedback can enhance paramedic participation and optimize trial outcomes.
• Sharing learning from trials like PARAMEDIC2 is vital for advancing OHCA research.