"No thank you": Why elderly patients declined to participate in a researchstudy

Objectives: To compare the population consenting for a study of the effecti veness of a pharmacist-run medication review clinic with the population not consenting for patients aged over 65 years old with respect to age, sex an d number of repeat medicines. To explore the reasons why some patients decl ined to consent to the study. Methods: Letters were sent to 2,403 patients aged 65 and over and taking at least one repeat medicine from 4 general practices. If no reply was receiv ed to a second letter they were followed up by telephone. If they declined to consent they were asked for their reasons. Data for consenting and non-c onsenting patients was collected on the stratification factors: age, sex an d number of repeat medicines. Multiple logistic regression was used to asse ss the association of each factor with consent rates. Results: Consenting patients were dissimilar to non-consenting patients. Pa tients were less likely to consent if they were older, OR (95% CI) = 0.54 ( 0.46,0.64), or female, OR (95% CI) = 0.74 (0.63,0.88). Patients were more l ikely to consent if on 5 or more repeat medicines: OR (95% CI) = 1.3 (1.1,1 .5). Ten broad categories of reasons why patients did not wish to participa te were identified from the patient interviews. Conclusions: Patients were less likely to give their consent if they were e lderly, female and on fewer repeat medicines. A number of administrative an d behavioural factors were identified which reduced the chances of informed consent being given. These factors need to be addressed to maximise number s of consenting patients in medication review studies.