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

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.

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Bibliographic Details
Main Authors: Silva,T.R. da, Luvizutto,G.J., Martins,L.G., Costa,R.D.M. da, Souza,J.T. de, 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., Edwards,T.G.S., Pontes-Neto,O., Conforto,A.B., Bazan,R.
Format: Digital revista
Language:English
Published: Associação Brasileira de Divulgação Científica 2023
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2023000100603
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