0488 Exploring Study Recruitment Trends in the Acute Post-Stroke Setting

Abstract Introduction Obstructive sleep apnea (OSA) is a form of sleep-disordered breathing due to intermittent upper airway closure causing hypoxia, sympathetic activation, and hemodynamic changes that impact cerebral blood flow during sleep and predispose to ischemia. OSA is a well-established independent risk factor for acute ischemic stroke (AIS) with a prevalence estimate ranging from 60-80%. The Recovery in Stroke Using Positive Airway Pressure (RISE-UP) clinical trial is an ongoing study designed to investigate the influence of OSA treatment with continuous positive airway pressure (CPAP) on post-stroke functional recovery in both the subacute and acute post-AIS setting. Methods The RISE-UP trial recruits patients admitted to Yale-New Haven Hospital, a large academic medical center in an urban location. Over a period of three years, 3507 patients have been screened for the study. Preliminary data was analyzed for trends in recruitment. Exclusion criteria included being unable to consent for themselves, past use of CPAP, and an estimated life expectancy of less than six months. Passive refusal can be defined as when patients choose not to enroll or participate without actively expressing a refusal. Results Of the 1109 (31.6%) patients deemed eligible for the study, 705 (63.6%) were approached, 171 (24.2%) consented to participate, and 489 (69.3%) refused. Among those who refused, the most common reasons were lack of interest (58.8%), passive refusal (21.7%), feeling overwhelmed (12.3%), and family discouragement (4.1%). Conclusion The recruitment data presented provides useful insight into the potential challenges of recruitment in the immediate post-stroke setting. In particular, the most common reasons for refusal included lack of interest, passive refusal, and feeling overwhelmed. Based on these findings, more robust education regarding the pertinence of OSA screening in those at risk for cardiovascular disease, such as stroke, and the relationship between OSA and AIS may increase enrollment among this patient population in the future. By understanding patient’s concerns and collaborating with the healthcare system, this analysis serves as a valuable opportunity to aid in recruitment efforts within this domain. Support (if any)