118 Chapter 5 5 Practice recruitment Practices are identified via a database search of all primary care practices in the Netherlands. Practices are invited to participate via a letter containing study information and an information folder. Practices are followed-up via telephone contact and email. In addition to invitations, indirect approaches such as presentations at conferences, professional development events for HCPs and word of mouth are used to recruit practices. Before enrolment, practices sign a data processing agreement which allows selection and invitation of potentially eligible patients on behalf of the practice by research staff. This approach allows us to keep the burden for general practices to a minimum, and at the same time to reach an adequate patient sample. Patient recruitment Initially, patients are recruited only from enrolled practices. However, due to low inclusion numbers, mainly caused by the increased workload in primary care practices during the COVID-19 pandemic, we broadened the recruitment strategy with recruitment via public channels (i.e., social media and newspaper advertisement) and recruitment via pharmacies. Adding these two alternative recruitment strategies means that eligible patients recruited via these routes do not need to be registered at participating practices but do need to meet all further eligibility criteria. Also, inclusion criteria are checked by the general practitioner in each route. As such, patients can be recruited via the following three routes (partly overlapping at some stages). Route A (recruitment via general practices) Eligible patients are selected through electronic record screening by a research assistant or by the practice following an instruction sheet. Invitation letters with an expression of interest form and a reply envelope are sent on behalf of the general practitioner to all eligible patients. Patients can also express their interest via the study website with an identification code included in the letter. Non-responders are sent a reminder letter after two to three weeks. Furthermore, general practices are asked to contact non-responders. Route B (recruitment via public channels) Potentially eligible patients are recruited via public channels including (local) newspapers, social media channels and patient organisations by using a visual advertisement including a link to the study website containing more details on the study. Potentially eligible patients expressing their interest to participate are contacted and screened telephonically on eligibility. The general practice where the potential patient is registered is contacted to discuss participation of the general practice (i.e., inviting all eligible patients from the practice following ‘route A’). Practices that are not interested in study enrolment are asked to check the inclusion criteria only.
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