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 recr...

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Detalles Bibliográficos
Autores: da Silva, T. R. [UNESP], Luvizutto, G. J., Martins, L. G. [UNESP], da Costa, R. D.M. [UNESP], de Souza, J. T. [UNESP], Winckler, F. C. [UNESP], Sartor, L. C.A. [UNESP], Modolo, G. P. [UNESP], Ferreira, N. C. [UNESP], Rodrigues, J. C.S. [UNESP], Kanda, R. G. [UNESP], Fogaroli, M. O. [UNESP], Borges, G. F. [UNESP], Rizzatti, G. R.S. [UNESP], Ribeiro, P. W. [UNESP], Pires, D. S., Favoretto, D. B., Aguiar, L. R., Bazan, S. G.Z. [UNESP], Betting, L. E.G. [UNESP], Antunes, L. C.O. [UNESP], Nunes, H. R.C. [UNESP], Pereira, V. M., Edwards, T. G.S., Pontes-Neto, O., Conforto, A. B., Bazan, R. [UNESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Brasil
Institución:Universidade Estadual Paulista (UNESP)
Repositorio:Repositório Institucional da UNESP
Idioma:inglés
OAI Identifier:oai:repositorio.unesp.br:11449/248290
Acceso en línea:http://dx.doi.org/10.1590/1414-431X2023e12326
http://hdl.handle.net/11449/248290
Access Level:acceso abierto
Palabra clave:Clinical trial
Rehabilitation
Stroke
Transcranial direct current stimulation
Unilateral spatial neglect
Descripción
Sumario: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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