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

• Published in: The western journal of emergency medicine Vol. 24; no. 2; pp. 228 - 235
• Main Authors: Worth, Lindsay M, Macias-Konstantopoulos, Wendy, Moy, Lauren, Perl, Harold I, Crandall, Cameron, Chavez, Roberta, Forcehimes, Alyssa, Mandler, Raul, Bogenschutz, Michael P
• Format: Journal Article
• Language: English
• Published: United States University of California Digital Library - eScholarship 20.02.2023; Department of Emergency Medicine, University of California, Irvine School of Medicine; eScholarship Publishing, University of California
• Subjects: Adult; Behavioral Health; Clinical trials; Crisis Intervention; Drug use; Emergency medical care; Emergency Service, Hospital; Humans; Longitudinal Studies; Motivation; Retention; Substance use disorder; Substance-Related Disorders - diagnosis; Substance-Related Disorders - therapy; United States; United States
• ISSN: 1936-900X; 1936-9018; 1936-9018
• DOI: 10.5811/westjem.2022.11.57179

Clinical trial recruitment and retention of individuals who use substances are challenging in any setting and can be particularly difficult in emergency department (ED) settings. This article discusses strategies for optimizing recruitment and retention in substance use research conducted in EDs. Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED) was a National Drug Abuse Treatment Clinical Trials Network (CTN) protocol designed to assess the impact of a brief intervention with individuals screening positive for moderate to severe problems related to use of non-alcohol, non-nicotine drugs. We implemented a multisite, randomized clinical trial at six academic EDs in the United States and leveraged a variety of methods to successfully recruit and retain study participants throughout the 12-month study course. Recruitment and retention success is attributed to appropriate site selection, leveraging technology, and gathering adequate contact information from participants at their initial study visit. The SMART-ED recruited 1,285 adult ED patients and attained follow-up rates of 88%, 86%, and 81% at the 3-, 6-, and 12-month follow-up periods, respectively. Participant retention protocols and practices were key tools in this longitudinal study that required continuous monitoring, innovation, and adaptation to ensure strategies remained culturally sensitive and context appropriate through the duration of the study. Tailored strategies that consider the demographic characteristics and region of recruitment and retention are necessary for ED-based longitudinal studies involving patients with substance use disorders.