Optimizing Recruitment and Retention in Substance Use Disorder Research in Emergency Departments

Area of Science:

• Clinical Research
• Substance Use Disorders
• Emergency Medicine

Background:

• Clinical trial recruitment and retention of individuals who use substances present unique challenges, especially within emergency department (ED) settings.
• Optimizing strategies for substance use research in EDs is crucial for advancing treatment efficacy and understanding.
• The Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED) protocol specifically addresses these challenges.

Purpose of the Study:

• To describe the methods and outcomes of a multisite randomized clinical trial focused on individuals with substance use disorders in academic EDs.
• To highlight successful recruitment and retention strategies employed in the SMART-ED protocol.
• To provide insights into effective participant engagement for longitudinal substance use research in emergency settings.

Main Methods:

• Implementation of the SMART-ED protocol, a National Drug Abuse Treatment Clinical Trials Network (CTN) study, across six academic EDs in the United States.
• Utilizing a variety of methods including appropriate site selection, leveraging technology, and gathering comprehensive contact information to facilitate participant recruitment and retention.
• Conducting a randomized clinical trial assessing a brief intervention for individuals with moderate to severe non-alcohol, non-nicotine drug use problems.

Main Results:

• Successfully recruited 1,285 adult ED patients into the SMART-ED study.
• Achieved high follow-up rates: 88% at 3 months, 86% at 6 months, and 81% at 12 months.
• Demonstrated the importance of adaptive, culturally sensitive, and context-appropriate retention protocols in longitudinal research.

Conclusions:

• Effective recruitment and retention in ED-based substance use disorder research necessitate tailored strategies.
• Demographic characteristics and regional factors must be considered when developing study protocols for diverse patient populations.
• Longitudinal studies in ED settings require continuous monitoring and adaptation of retention practices to ensure participant engagement and data integrity.