Supporting recruitment of community pharmacies for the STOP trial training using an embedded recruitment model (Russian doll approach)

Problem

The Smoking Treatment Optimisation in Pharmacies (STOP) clinical trial is evaluating an intervention to increase throughput in the NHS Smoking cessation service in community pharmacies. This is because the pharmacy led service has experienced mass decommissioning due to low rates of smokers coming through the service. As part of the trial, we aimed to recruit 60 community pharmacies and a minimum of 120 staff, and to consent 1200 smokers over 11 months.Aim: To establish an effective strategy to achieve target numbers.

Approach

We adopted a hierarchical recruitment strategy. Stop smoking service commissioners from six London boroughs, Coventry in England, and Cwm Taf in Wales were sent the study synopsis by email. Potential participant pharmacies were identified by commissioners who sent promotional emails. The STOP team subsequently approached the pharmacy decision maker by phone or email. The pharmacy lead stop smoking advisor identified staff for training. Smoker recruitment figures were obtained by data download from commissioners.

Findings

Seven commissioners were recruited and one declined. 57 pharmacies were successfully recruited in London (29), Coventry (19) and Cwm Taf (9), with recruitment in Wales ongoing. 146 staff were recruited, 98 smoking advisors and 48 support staff achieving the staff recruitment target. However, preliminary results from the 4 service commissioners' data show that 161 smokers joined the service in first 6 months. 22 pharmacies recruited no smokers to the NHS smoking cessation service. 72 smokers were consented to the STOP trial from 15 of the 57 pharmacies.

Consequences

We confirmed that a Russian doll model provided a hierarchical structure which optimised recruitment by fostering links with key gate keepers at each level. However, smoker recruitment to the trial by participating pharmacy staff seems to be more challenging. Several insights from stop smoking advisors on the challenges of smoker recruitment are vital.