Limitations
SECONDARY, RECRUITMENT
We note above limitations related to the primary and secondary outcomes. There are additional important limitations. While initially intended as a randomized controlled trial with propensity matching to TREC units not participating in SCOPE, two problems were encountered that were eventually insurmountable, resulting in the quasi-experimental design reported here. Firstly, the number of LTC homes in the sampling frame was exhausted before the intended sample size was reached. Secondly, to maintain the size of our control cohort in a potential 1:1 match, we had to return homes that had declined to participate to the general pool, potentially introducing a bias to the comparator group. Despite the close working relationships established with many of the homes, and our previous experience with this intervention, recruitment was more challenging than originally anticipated [