Considerations on the Obstacles That Lead to Slow Recruitment in a Pain Management Clinical Trial: Experiences from the Belgian PELICAN (PrEgabalin Lidocaine Capsaicin Neuropathic Pain) Pragmatic Study.

"Disclosure The PELICAN Investigators Team consists of Jan Pieter Haems, Mirella Dingens, Frans Van De Perck, Michel Dangoisse, Olivier De Coster, Nathalie Mathieu, Milica Matic, and Bart Morlion. Conflicts of Interest The authors declare that they have no conflicts of interest."

"Special thanks are due to the members of the Trial Steering Committee for their continued support, practical suggestions, and advice during the difficult execution of the study. Your input was already highly appreciated. The authors would like to express their special gratitude and thanks to the external experts, Prof. Ralf Baron and Prof. Kris Vissers, for their willingness to support this trial and guide them with many practical suggestions. Furthermore, the authors would also like to acknowledge with much appreciation the colleagues from the University of Antwerp (UA), more specifically from the Department of Primary and Interdisciplinary Care (ELIZA). Their support and contributions in the creation of the protocol of the original pragmatic trial but certainly later for the structuring and execution of the qualitative research proved to be crucial. Sincere thanks go to the entire team of the Clinical Trial Center (CTC). They have invested their full effort in supporting the study team in achieving this study project. The authors greatly appreciate their guidance throughout the different steps of the process and their numerous suggestions to improve the protocol but also lift the execution of the study to a higher level. Finally, the entire study team would like to express their gratitude towards the funder KCE for their continued investment in this project, their kind cooperation, and continued encouragement to get this study project going. Special thanks go to Hilde Nevens and France Vrijens for their continued support during the different study phases. The PELICAN trial and the qualitative study were fully and exclusively funded by the Trials program of the Belgian Health Care Knowledge Centers."

"Conclusion: The findings of the qualitative study demonstrate the need for further, more varied LNP research in Belgium, not limited to pharmacological studies. It also sheds important light on the recruitment obstacles that may be faced during these studies. Future studies could support this research by offering better proposals for feasibility and recruitment, for instance, by designing and conducting a compelling pilot study or applying social media during the recruitment phase. Clinical Trials. This trial is registered with NCT03348735. EUDRACT number 2018-003617-17."