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Patient level barriers (perceived by GP)
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Patient unwilling to participate
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“Patients who were well controlled on [Diskus] and Turbuhalers were very reluctant to change over to Seretide [Advair] MDI and about 3 patients refused to enter study for this reason.”
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Patients unavailable to participate
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“Some patients were geographically unavailable: [they worked as fly-in-fly-out employees in mines in Western Australia], some changed address.”
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GP level recruitment barriers
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Few eligible patients perceived by GP
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“I don't think you could have done any more. I guess most of my patients have well-controlled asthma!”
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Difficulty prioritizing research due to perceived demands of study or time constraints
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“You did a lot to assist recruitment. The excessive amounts of work involved put us off the desire. We then did not give much effort.”
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Confusion about recruitment information
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“When invited to participate I agreed because I had patients on Symbicort and Seretide. Unfortunately by the time I entered the study only Seretide was an option. I was not prepared to swap patients off Symbicort (my drug of choice).”*
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Study thought to be too intellectual or confronting for patients
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“I feel your program is too intellectual for ordinary patients who find instructions too difficult and give up & avoid anything too confronting and being shown up by other parties is unhelpful.”
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Confusion around disease diagnosis and management
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“Asthma/COAD i.e. Patient was diagnosed with asthma in the past and later diagnosed with COAD by specialist.”
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Practice/organization level barriers
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GP not empowered to recruit within a group practice
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“I had a poster in my [office], this did result in some patients volunteering when they read [the] notice (our waiting room is very large and we are prohibited to putting up such posters).”
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“As I am a new GP here I could not/did not try to recruit other doctor's patients into the study. I did not want to take other doctors patients unless they spontaneously moved to see me”.
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Study level barriers
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Need for more recruitment support
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“If a personnel from MICA was sent to help with recruitment that will be a great help for us or for future sites.”
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Study materials needed in languages other than English
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“I have a lot of patients with limited English, explanation (how to use spacer etc.) in [a language] other than English will help for some.”
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Lack of incentive for patient
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“It was very hard to convince the patients to participate. [There was] not much incentive.”
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GP level recruitment enablers
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Good recruitment support
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“No! The support and induction processes were excellent.”
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Study perceived as beneficial to GPs practice
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“MICA study was beneficial personally in learning some new techniques and also had satisfaction [in] that it helped my patients in many ways to improve control and understand their condition.”
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