Recruitment and Retention Strategies in Clinical Trials for Hip Fractures: A Cross-Sectional Analysis

Objective:To investigate the recruitment and retention strategies in clinical trials evaluating hip fractures, with a focus on underrepresented populations.Background:The prevalence and burden of hip fractures necessitate diverse and representative clinical trials to improve management outcomes. Underrepresented populations often face barriers to participation, affecting the generalizability of trial results.Methods:We conducted a cross-sectional analysis of clinical trials on hip fractures published between 2018 and 2023. We searched Embase and MEDLINE, screening and extracting data in a masked duplicate manner. For statistical analysis, Stata 18 SE (StataCorp LLC) was used to determine frequencies of recruitment and retention strategies.Results:We screened 624 studies, with 72 meeting our inclusion criteria. Trials were conducted in the United States (12/72, 16.7%), non-United States (53/72, 73.6%), or both (7/72, 9.7%). Only one trial (1.4%) mentioned specific recruitment strategies, and three (4.2%) reported measures to minimize participant dropout. Overall, the mention of strategies for diverse participation was scarce.Conclusion:There is a notable lack of recruitment and retention strategies directed at promoting diverse participation in hip fracture trials. This study highlights the need for improved inclusiveness and equity in future clinical trials to enhance the generalizability of their findings and better serve all populations affected by hip fractures.