Conclusion
Our research exemplifies the new, participant-centric, direction in delivering clinical trials outlined in the Airlie House Guidelines [The lack of association between person-specific variables and trial participation found in our study may suggest that engagement with a clinical trial is also dependent on design factors. Even when many of the design barriers raised by MND–SMART patient–public representatives were addressed, or minimised, in MND–SMART some sub-groups of people remained less likely to participate, and at a higher risk of attrition.Further work to establish how individuals in these sub-groups may benefit from tailored interventions to support participation, and facilitate retention, is needed to effectively recruit and retain those currently under-represented in trial outcome data.