How Technology Can Help Achieve the Triple Aim of Clinical Trial Recruitment
When the word “technology” is used in conjunction with clinical trials, many people think of how technological advancements have impacted the actual studies themselves. Wearables, mobile monitoring and the gamification of studies are just three areas gaining traction.
But let’s go back to basics. Clinical trials require participants, and recruitment is one area where study sponsors can use technology to their advantage.
Unfortunately, three primary barriers still stand in the way of study participation. It’s a clinical trial trifecta:
Just as the search for the perfect mate has evolved from the traditional matchmaker to today’s online dating sites and apps, the search for a clinical trial match has led patients and caregivers to the internet. However, this medium is designed to be an interactive experience, not one-way communication. Today’s internet is all about connectivity, and in the world of clinical trials all involved parties ― study sponsors, researchers at clinical trial sites, advocacy groups, recruitment partners and patients ― must be connected and vetted via available technology.
Following are a few examples of how clinical trial sponsors ― and, with a few tweaks here and there, any healthcare professional ― can use technology to boost public knowledge and accessibility.
Gone are the days when patients would pick up the phone to ask their family physician about health symptoms. Instead, they pick up their laptop or mobile phone to search the web for instant answers. In fact, 80 percent of internet users, or about 93 million Americans, have searched for a health-related topic online, according to a study released by the Pew Internet & American Life Project.
So it goes to reason that those searching for clinical trial information will also gravitate toward online sources. However, trying to find a relevant clinical trial online can be like looking for a needle in a haystack. Simple tech tweaks such as search engine optimization and a robust on-site search engine can act like a magnet for that elusive needle.
This presents a huge opportunity for the pharmaceutical industry, whose public perception has been sullied by the recent drug price controversy. While there has been a big push for drug price transparency, both the public and government have been less vocal when it comes to clinical trial transparency. Patient advocates and advocacy groups have led the charge, but despite their efforts many patients still can’t find relevant clinical trials ― and many are simply in the dark about the clinical trial process itself.
Lack of awareness and lack of access go hand in hand with a lack of understanding. Due to language and educational barriers, minorities are often underrepresented in clinical trials. This is why health literacy ― the practice of presenting complicated health information in a manner that’s easily understood ― is so important for clinical trials.
Lack of diversity in clinical trials has long been a topic of contention in the healthcare community. The NIH Revitalization Act of 1993 requires all federally funded clinical research to prioritize the inclusion of women and underserved racial and ethnic groups. Yet statistics show that from 1993 to 2013, less than 2 percent of cancer studies, for example, included enough of those groups to report relevant results. Many minorities have a deep-seated mistrust of clinical trials, based on previous trials that lacked transparency, such as the infamous Tuskegee study of 1932. For these groups in particular, education and engagement are essential.
Word of mouth ― online, that is ― is an effective way for sponsors to increase clinical trial participation among any population. It’s important, therefore, that sponsor websites enable visitors to easily share trial information on social networks. Patient communities serve as support groups, providing online havens for those suffering from both common and rare diseases, and social sharing is rampant.
Financial status and impact on daily routines also discourage individuals from participating in clinical trials. Some patients have to pay for associated costs ― such as travel to and from study sites ― out of pocket. Clinical trial participation often requires time away from work, and numerous clinician visits are disruptive and inconvenient. One solution slowly gaining traction is to use technology to conduct hybrid or virtual trials, minimizing hardships for participants.
Geographical location presents another stumbling block for patients. Those who live in rural areas may simply not be aware of any nearby trials. To help them in their search, a sponsor’s website should include location-based search functionality to provide timely, relevant results.
The typical screening process for clinical trial candidates is a lengthy process. Use of technology can eliminate inefficiencies and minimize frustration on the part of both patients and sponsors.
It’s important to maintain communication with participants before, during and after a trial. Today’s technology is smart enough to reconnect with interested patients/families who didn’t originally qualify but, based on new criteria, may now be a good fit. A recommendation engine, for example, can analyze information provided by a patient online to offer suggestions regarding applicable trials.
A 2019 announcement by the Food & Drug Administration (FDA), easing unnecessary restrictions on clinical trial participation, was a step in the right direction. However, if patients cannot easily find relevant clinical trial information online, this bold move by the FDA will be fruitless. Study sponsors must seize this unique opportunity and ensure their clinical trials are properly disclosed, include accurate site information and connect interested patients to study coordinators.
Making a concerted effort to increase online awareness, access and eligibility for clinical trials is a good start. In order to maintain momentum, study sponsors must employ analytical tools so they can continue to fine-tune their online content to keep visitors on their website and improve conversions.
The ball is now in the study sponsors’ court. In order to increase clinical trial participation, they first must educate the public, building trust along the way. Providing information and access to patients will empower them to make educated decisions about their healthcare and ultimately lead to improved outcomes.