From travel burden to up front expenses, to juggling work and family commitments, there’s no denying that traditional site-based clinical trials place huge demand on participants.
Not only do these demands contribute to high patient drop-out rates, the level of commitment often prevents patients from enrolling in vital studies in the first place. When patients also have complex medical needs due to rare or life-altering conditions, the burden of participation becomes even greater, as it has the potential to take a greater toll on physical and mental wellbeing.
Every time a patient drops out of a clinical trial, the cost to replace them rises exponentially. According to Clinical Leader, 85% of trials fail to retain enough patients and nearly 80% of studies fail to finish on time due to patient dropout. This makes investing in patient retention critical – especially trials for rare diseases, with limited patient pools to begin with.
The 2020 technology boom
When the COVID-19 pandemic hit, clinical trials became even more demanding for patients. Suddenly, there were more hoops to jump through to comply with safety protocols – not just on sites, but also when it came to travel and accommodation.
Despite the challenges though, the pandemic also showed us the myriad ways technology could be used to enhance communication with patients, enabling important work to continue when face-to-face contact and long-distance travel wasn’t possible.
The technology boom across all sectors fast-tracked and enabled Decentralised Clinical Trials (DCTs) and hybrid models in a way we’ve hoped to see for years. And the good news is, it looks like these changes are here to stay.
In a recent study by Oracle Health Sciences,76% of respondents said they had accelerated their decentralised trials since 2020. The COVID-19 vaccine trials have been some of the largest in history and without technology, they wouldn’t have been possible amidst the disruption to travel and contact caused by the pandemic.
Taking the site to the patient
A huge part of site-based trial logistics is getting patients where they need to be. 70% of potential study participants live more than two hours from the nearest study site. Many will have to drive for even longer, and when it comes to rare diseases, patients are usually required to travel internationally and stay close to sites for weeks at a time.
Travel has a big impact on patient retention because it adds significantly to the time commitment required to take part in a study. When patients are unwell, or have complex healthcare needs, travelling long distances can really take its toll.
However, when we embrace the potential of technology to organise and deliver mobile health services such as home visits by nurses to gather readings or administer treatment, or enable data capture through wearable devices and apps, we can significantly increase patient recruitment and retention. Instead of taking the patient to the site, we take the site to the patient.
Home visits might not be able to replace every single site visit in all clinical trials. But if at least a handful of visits can be conducted via mobile health, we can reduce the travel burden on patients significantly.
Giving patients choice
One of the biggest benefits new technologies bring to clinical trials is giving patients choice about their participation – including whether they travel, how far they travel, when their appointments are, how they capture data and how they communicate with study organisers.
Many existing platforms enable and enhance patient communication, whether it’s sending reminders about appointments through their smartphones, arranging for healthcare providers to visit their homes, or to liaise with them via telehealth. And throughout the industry, we’re seeing infrastructures, systems and platforms continually evolving to deploy these new technologies.
It’s clear the more we can integrate various technologies across all phases of the clinical journey, the easier we make it for patients to participate in vital studies with minimal disruption to their day-to-day lives.
Empowering patients through technology
People are happiest when they feel empowered. And technology can empower patients by giving them autonomy and control over their clinical trial participation.
When patients have control over when they set their appointments, whether they have someone come to them, or even whether they complete appointments through telehealth using a smartphone, they’re far more likely to stay enrolled and engaged.
Wearables and sensors and other disruptive health technologies are hugely powerful in clinical trials. These can be anything from patches that stick to the skin and track heart rate or muscle contractions, noninvasive blood glucose meters that don’t need a finger prick, or pill cams that can be ingested and take real time data.
Not only do these give patients an important feeling of bodily autonomy, but they enable clinical researchers to gather and report on real-world data, in real time. Patients are empowered, and more applicable, relevant data can be gathered while giving patients the flexibility and care they deserve.
Keeping patients engaged
It’s essential technology is used to facilitate communication in Decentralised Clinical Trials – whether that’s video calls, providing reminders to complete diaries or book appointments, or organising and deploying home health visits. Technology should also be used to check in and provide patient support and ongoing care.
As well as improving patient engagement throughout the clinical trials, technology can also help to streamline and improve the consenting process. Through technology, you can communicate necessary information to the patient, explain the trial and follow up process, and obtain informed consent in a far more efficient manner while maintaining HIPAA compliance.
This is just one example of how an essential part of clinical trial participation can be streamlined and improved through technology, and that can make a big difference to patient engagement and retention.
Integrating technology into patients’ lives
When it comes to using technology in clinical trials, it doesn’t have to be the newest, fanciest, most high-end. Some patients just want to be interacted with by a simple text message – and know they can reach out to someone easily when they have questions via an app, or video call.
Every year, technology integrates more and more deeply with our day to day lives – whether it’s video calling, smart homes, or social media. Integrating clinical trial technologies with devices patients use daily is incredibly important – not only for patients, but sites as well.
Ensuring different technologies and platforms integrate prevents patients from having to work within several different platforms, and means sites won’t have to log into multiple different accounts for one trial.
The great news is, most of the technologies being developed work on systems that can be integrated with smartphones, smartwatches, and tablets. This means they can be used properly, regularly, and effectively – while enabling us all to work together, better, across the industry.