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Recruitment of ethnic minority patients to a cardiac rehabilitation trial: The Birmingham Rehabilitation Uptake Maximisation (BRUM) study [ISRCTN72884263]

Jolly, K and Lip, G.Y.H. and Taylor, R.S. and Mant, J.W.F. and Lane, D.A. and Lee, K.W. and Stevens, A.J. (2005) Recruitment of ethnic minority patients to a cardiac rehabilitation trial: The Birmingham Rehabilitation Uptake Maximisation (BRUM) study [ISRCTN72884263]. BMC Medical Research Methodology, 5 (18). ISSN 1471-2288

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URL of Published Version: http://www.biomedcentral.com/content/pdf/1471-2288-5-18.pdf

Identification Number/DOI: 10.1186/1471-2288-5-

Background
Concerns have been raised about low participation rates of people from minority ethnic groups in clinical trials. However, the evidence is unclear as many studies do not report the ethnicity of participants and there is insufficient information about the reasons for ineligibility by ethnic group. Where there are data, there remains the key question as to whether ethnic minorities more likely to be ineligible (e.g. due to language) or decline to participate. We have addressed these questions in relation to the Birmingham Rehabilitation Uptake Maximisation (BRUM) study, a randomized controlled trial (RCT) comparing a home-based with a hospital-based cardiac rehabilitation programme in a multi-ethnic population in the UK.

Methods
Analysis of the ethnicity, age and sex of presenting and recruited subjects for a trial of cardiac rehabilitation in the West-Midlands, UK.

Participants: 1997 patients presenting post-myocardial infarction, percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery.

Data collected: exclusion rates, reasons for exclusion and reasons for declining to participate in the trial by ethnic group.

Results
Significantly more patients of South Asian ethnicity were excluded (52% of 'South Asian' v 36% 'White European' and 36% 'Other', p < 0.001). This difference in eligibility was primarily due to exclusion on the basis of language (i.e. the inability to speak English or Punjabi). Of those eligible, similar proportions were recruited from the different ethnic groups (white, South Asian and other). There was a marked difference in eligibility between people of Indian, Pakistani or Bangladeshi origin.

Conclusion
Once eligible for this trial, people from different ethnic groups were recruited in similar proportions. The reason for ineligibility in the BRUM study was the inability to support the range of minority languages.

Type of Work:Article
Date:17 May 2005 (Publication)
School/Faculty:Schools (1998 to 2008) > School of Medicine
Department:Department of Primary Care and General Practice
Subjects:R Medicine (General)
Institution:University of Birmingham
Copyright Holders:BioMed Central
ID Code:51
Refereed:YES
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