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Table 3 Summary of possible strategies that might improve feasibility in terms of recruitment, missing values and patient satisfaction

From: Lessons learned from a randomized controlled trial on a home delivered meal service in advanced cancer patients undergoing chemotherapy: a pilot study

Recommendations

Recruitment and inclusion

- Expand inclusion criteria to increase the number of eligible patients and improve generalizability.

- Include more recruitment centers to increase the number of eligible patients as soon as a delayed recruitment is noticed.

- Inform eligible patients about the possible course of nutritional symptoms during chemotherapy when asking them to participate.

- Inform eligible patients that the burden of participation will be kept as low as possible (no additional hospital visits, non-invasive procedures etc.).

- Keep recruiting staff motivated by sending them newsletters about the study, speak with them face-to-face about eligible patients, involve them in the protocol writing or share positive responses of participants with them.

- Estimate the number of eligible patients in advance based on the in- and exclusion criteria.

Missing values

- Maintain close contact with the clinical nurse specialist about the planning of patients to prevent missing values at baseline.

- Pay extra attention to instructing participants on how to fill in questionnaires and diaries and evaluate afterwards.

- Emphasize the benefits of questionnaires and diaries in the communication with their practitioners to create motivation and increase compliance.

Patient satisfaction

- Combine study appointments with existing hospital appointments to prevent extra hospital visits.

- Minimize the number of different staff members having contact with the participants.

- Keep an overview of the studies that eligible patients are being asked to participate in to prevent that patients are overwhelmed with studies.