A randomized controlled trial was conducted to assess the efficacy of a computerized therapy programme for depression and anxiety, ‘Beating the Blues’, compared with cognitive-behaviour therapy provided by clinical psychologists and treatment as usual by general practitioners (GPs). The aim of the paper is to describe the study, the problems that were encountered when GPs agreed to recruit participants during consultations and to outline possible solutions to these problems. After three months only five participants had been recruited prompting modification of the study design. After one year only 17 patients had been recruited and the study was discontinued. The GPs indicated that the randomization procedure compromised their traditional role of providing patients with the best possible treatment. This produced role conflict that was resolved by GPs adhering to their care-giving role at the expense of recruiting to the study. GPs also felt that discussion of research took too much time during consultations and was inappropriate given that patients were often somewhat distressed. They also did not see the three treatment arms as equally acceptable, which resulted in GPs failing to recruit patients in case they were randomized to what they considered to be inferior treatments. Competing demands that rendered the study a low priority were also reported. We incorporated suggested solutions to these problems into the study which was rerun and completed after one year with 40 patients having been recruited.

The objective was to explore the feasibility of prospective recruitment of general practice patients to a future trial on the effects of paracetamol on the symptoms of the common cold. In October 2000, recruitment letters were sent by a general practitioner to 276 patients aged between 18 and 75. 65 patients returned signed consent forms. Postal packs were sent to the first 60 of these patients to reply. They contained a daily diary, symptom score questionnaires, an EQ-5D questionnaire, a pack of paracetamol tablets, and detailed instructions. When a cold developed and symptoms reached a specified level, one gram of paracetamol was taken four times daily for two days and questionnaires were completed for four days. Telephone interviews and crosschecking of data were used to identify difficulties in completing the study. The overall recruitment rate was 24% (65/276) with 95% confidence interval 19% to 29%. Recruitment was significantly higher (p < 0.001) amongst patients registered with the main researcher (43% (29/68)) than with other doctors in the practice. The response rate, i.e., those who returned completed study packs, was 77% (46/60). Thirty participants experienced a cold and returned their data during the six months of the study, representing 50% (30/60, 95% Cl 37% to 63%) of participants and 11% (30/276, 95% Cl 7% to 15%) of those initially approached. The mean cumulative four-day symptom score was 34.6, standard deviation 14.7. The EQ-5D health status on day four was 0.89. We conclude that a prospective postal recruitment method in general practice is a potentially useful method of conducting research on the common cold. A better response is obtained when the initial letter is signed by the patient's own doctor.