Non-specific mechanisms in orthodox and complementary /alternative management of back pain (The MOCAM Study): recruitment rates and challenges

Purpose and BackgroundThe MOCAM study is a major prospective questionnaire-based study investigating the relationship between low back pain (LBP) patient outcomes and non-specific treatment components, i.e., therapeutic relationship, healthcare environment, incidental treatment characteristics, patients' beliefs and practitioners' beliefs. Participating acupuncturists, osteopaths, and physiotherapists from the NHS and private sector have been asked to recruit at least 10 patients into the study. This paper aims to analyse current recruitment rates from MOCAM and identify barriers and facilitators to effective recruitment.Methods and ResultsRecruitment has taken place over 15 months. Invitation letters or emails were sent to individual practitioners identified using online search tools and professional networks. Recruitment rates were analysed descriptively. Within the private sector, response rates (number participating/number invited) are: acupuncturists 3% (49/1561), osteopaths 6% (53/912), physiotherapists 4% (40/1048). Private sector practitioners have each recruited on average 1, 4, and 2 patients into the study respectively. Within the NHS, the response rates are: acupuncturists 100% (2/2), osteopaths 8% (1/13), physiotherapists 63% (44/70). NHS practitioners have each recruited on average 4, 3, and 2 patients respectively.ConclusionsRecruiting practitioners has been challenging. While the response rates in the NHS are higher than in the private sector the absolute number of acupuncturists and osteopaths participating from the NHS is very low. This may be due to changes in the NHS commissioning landscape. However, further investigation is required to confirm this. The higher recruitment rates of patients from NHS settings may reflect different patient populations across sectors.No conflicts of interestFunding: This work was supported by Arthritis Research UK Special Strategic Award grant number 20552.