ArticleBMJ open2019
Exploring non-retention in clinical trials: a meta-ethnographic synthesis of studies reporting participant reasons for drop out.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Retention and Engagement in Culturally Adapted Digital Mental Health Interventions: Systematic Review of Dropout, Attrition, and Adherence in Non-Western, Educated, Industrialized, Rich, Democratic Settings.JMIR mental health · 2026Pooled it
- Pooled it
- The Challenges of Enrollment and Retention: A Systematic Review of Psychosocial Behavioral Interventions for Patients With Cancer and Their Family Caregivers.Journal of pain and symptom management · 2021Pooled it
- Strategies to improve retention in randomised trials.The Cochrane database of systematic reviews · 2021Pooled it
- The research burden of randomized controlled trial participation: a systematic thematic synthesis of qualitative evidence.BMC medicine · 2020Pooled it
- Pooled it
- A multidisciplinary pain management program for patients with chronic low back pain: a randomized, single-blind, controlled, feasibility study.BMC musculoskeletal disorders · 2025Trial
- Medical App Treatment of Non-Specific Low Back Pain in the 12-month Cluster-Randomized Controlled Trial Rise-uP: Where Clinical Superiority Meets Cost Savings.Journal of pain research · 2024Trial
- The efficacy of the "Talk-to-Me" suicide prevention and mental health education program for tertiary students: a crossover randomised control trial.European child & adolescent psychiatry · 2023Trial
- What influences communication about retention in randomised trials: a multi-trial, theory-based analysis exploring trial staff perspectives.BMC medical research methodology · 2022Trial
- Use of patient-reported outcome measures (PROMs) in clinical diabetes consultations: the DiaPROM randomised controlled pilot trial.BMJ open · 2021Trial
- Trial
- Beyond Usage Time: Rethinking Therapeutic Dose and Effect in Digital Therapeutics.JMIR mental health · 2026Article
- Detecting and Mitigating Bias for Inclusive and Trustworthy Clinical Research: A Scientific Statement From the American Heart Association.Circulation. Genomic and precision medicine · 2026Review
- Ethical Considerations in Transcranial Focused Ultrasound Neuromodulation for Disorders of Consciousness.Neuromodulation : journal of the International Neuromodulation Society · 2026Article
- The impact of the COVID-19 pandemic on healthy volunteer motivations: a mixed-methods study of participants in plague vaccine trials in the UK and Uganda.BMC public health · 2026Article
- Retention in trials: a qualitative evidence synthesis of studies reporting participant reasons for trial non-completion.BMJ open · 2026Review
- Why We Need a Dynamic Right to Withdraw in Individualized Antisense Oligonucleotide Therapy Development.Journal of bioethical inquiry · 2026Article
- Increasing Retention in a Trial by Supporting Basic Psychological Needs for Autonomy, Competence and Relatedness: Developing a Theory-Informed App-Based Complex Intervention.Scandinavian journal of caring sciences · 2026Article
- Clinical trial participant information leaflets overstate the harms/risks of participation and understate the benefits.PloS one · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
objectivesTo undertake a meta-ethnographic synthesis of findings from primary studies reporting qualitative data that have explored participant-reported factors influencing non-retention within a clinical trial context.
designA systematic search and meta-ethnography was conducted for published papers (from 1946 to July 2018) that contained qualitative data from trial non-retainers.
participantsWe identified 11 studies reporting qualitative data from 13 trials. The studies were undertaken between 2008 and 2018. Each study included between 3 and 40 people who had dropped out from a trial, with findings from 168 people in total reported across the papers.
resultsEmergent from our synthesis was the significance of trial non-retainers' perceptions around the personal 'fit' of key aspects of the trial with their personal beliefs, preferences, capabilities or life circumstances. These related to their own health state; preferences for receiving trial 'care'; individual capabilities; beliefs about or experiences of trial medication and considerations whether trial participation could be accommodated into their broader lives. All these factors raise important issues around the extent to which initial decisions to participate were fully informed.
conclusionsTo improve retention in clinical trials, researchers should work to reduce the burden on trial participants both through the design of the intervention itself as well as through simplified data collection processes. Providing more detail on the nature of the trial interventions and what can be expected by 'participation' at the consenting stage may prove helpful in order to manage expectations.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.