Using media to enhance pediatric patient recruitment in primary care

Context: Recruitment of study participants by general practitioners (GPs) is a general concern in primary care. Poor recruitment leads to extension or discontinuation of randomized controlled trials (RCTs) involving patients. In our RCT investigating the (cost)effectiveness of hypnotherapy in children with functional abdominal pain (FAP) and irritable bowel syndrome (IBS), recruitment of patients by GPs was problematic and was therefore extended to recruitment via media including social media.

Objective: To compare demographic, clinical and psychosocial characteristics of children with FAP and IBS who are recruited by their GP versus via media.

Study Design and Analysis: This ancillary study compared baseline data from an RCT between two groups based on recruitment method. Descriptive data were used to compare baseline characteristics.

Setting: GPs from local GP practices. Media recruitment consisted of spreading information via local schools, interest groups, local newspapers and social media posts, and advertising nationally via social media.

Population studied: Children aged 7-17 years with FAP or IBS according to their GP. Exclusion criteria were organic gastrointestinal disease, treatment by a pediatrician, intellectual disability, psychotic disorder, and previous hypnotherapy.

Outcomes: Age, gender, duration of abdominal pain symptoms, diagnosis based on Rome IV criteria, history of treatment by a pediatrician, pain severity, somatization scores, school absenteeism in the past three months, pain beliefs, anxiety and depression scores and health-related quality of life.

Results: A total of 152 children were included in the RCT. Overall, children recruited by GPs (n=46) did not differ from children recruited via media (n=106) on demographic, and most patient characteristics. However, children recruited via media had higher median symptom duration (2.5 years, interquartile range 1.5-4.6 years) compared to children recruited by their GP (1.2 years, interquartile range 0.5-4.6).

Conclusions: This study adds to the evidence that recruitment via media has limited impact on patient characteristics. Including media recruitment in research can promote sample size attainment, prevent discontinuation of RCTs and minimize research workload for GPs. We suggest to perform a subgroup analysis of recruitment strategy, because it might induce differences in baseline characteristics between groups that potentially affect prognosis or treatment effects.