Journal article
Distance from Home to Research Center: A Barrier to In-Person Visits but Not Treatment Adherence in a Stroke Trial
Neuroepidemiology, Vol.50(3-4), pp.137-143
2018
DOI: 10.1159/000486315
PMCID: PMC5975097
PMID: 29587267
Abstract
Clinical trials often seek to enroll patients from both urban and rural areas to safeguard the generalizability of results. However, maintaining contact with patients who live away from a recruitment site, including rural areas, can be challenging. In this research we examine the effect of distance between patient and study centers on treatment adherence and retention.
Secondary analysis of 2,466 participants in the Insulin Resistance Intervention after Stroke trial who were enrolled from research sites in the United States. Driving distance between the zipcodes of patient's reported place of residence and the study center was calculated. Outcome measures were loss to follow-up, completion of annual in-person visits, adherence to preventive therapy, and adherence to study drug in the first 3 years of participation. Logistic regression models were used to adjust for confounders.
Distance from residence to research center was not associated with loss to follow-up, adherence to study drug, or adherence to preventive therapy (p > 0.05 for each). However, patients who lived farther from the research center (>120 miles), compared to patients who lived closer (<60 miles), were less likely to complete the second annual in-person visit (62 vs. 81%; adjusted OR 0.48; 95% CI 0.31-0.75) and third visit (53 vs. 75%; adjusted OR 0.44; 95% CI 0.29-0.67).
Distance between patient and study center was an independent predictor of missed in-person visits but not with adherence to study treatment or preventive care.
Details
- Title: Subtitle
- Distance from Home to Research Center: A Barrier to In-Person Visits but Not Treatment Adherence in a Stroke Trial
- Creators
- Enrique C Leira - Public Health, Iowa City, Iowa, USACatherine M Viscoli - Yale School of Medicine, New Haven, Connecticut, USALinnea A Polgreen - Pharmacy, University of Iowa, Iowa City, Iowa, USAMark Gorman - Maine Medical Center, Portland, Maine, USAWalter N Kernan - Yale School of Medicine, New Haven, Connecticut, USA
- Resource Type
- Journal article
- Publication Details
- Neuroepidemiology, Vol.50(3-4), pp.137-143
- Publisher
- Switzerland
- DOI
- 10.1159/000486315
- PMID
- 29587267
- PMCID
- PMC5975097
- ISSN
- 0251-5350
- eISSN
- 1423-0208
- Grant note
- U01 NS044876 / NINDS NIH HHS
- Language
- English
- Date published
- 2018
- Academic Unit
- Neurology; Epidemiology; Economics; Iowa Neuroscience Institute; Pharmacy Practice and Science; Neurosurgery
- Record Identifier
- 9984020605002771
Metrics
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