2004 - 2007 - Cicely Saunders Institute - King's College London

Our trials using this design have achieved substantially
better uptake and recruitment than previous palliative
care randomised trials 232 . While many factors may have
contributed to our improved recruitment, to date we
have found the use of the MRC framework and the ‘fasttrack’
versus ‘current best practice’ design acceptable
to staff, patients, families, patient representative
organisations, funders and research ethics committees.
In both studies we have found that attention is needed to
decide the ‘correct’ period of control before the intervention
is offered. This had to be different in our two
studies - because we had to base it on how stable the
patients were and how quickly we expected the service
to have an effect. We have also found that using the
MRC Framework was more costly than traditional
designs, in the short term, because of the need to
undertake phase I and II work 232 . However, in the long
term, if the trial is successful it represents a good
investment in research, especially as traditional designs
have often failed.
Almost all studies within the department employ mixed
method approaches - where quantitative and qualitative
methods are used together, one informing the other. We
are further developing the ways that these methods are
integrated and work to give a rounded picture of the
issues faced by patients and families, whose problems
are usually complex and multi-dimensional, requiring a
multi-professional and multi-method approach, especially
to capture less tangible aspects such as quality of life,
quality of care, dignity and caregiver needs.
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