When asked about the biggest challenge they are facing, clinical trial professionals invariably bring up patient recruitment. Is it fair to call it the most important issue facing trials today? What is the solution? Here, three clinical insiders representing pharma, CROs, service providers and patient networks offer their views on the challenge of recruitment and how they are dealing with it.
Dr. Julie Vallortigara - Research Officer at Ataxia UK
‘By definition, for rare diseases we don't have that many patients living with that particular condition and if you want to try a new treatment, you need enough numbers...It's making sure you engage with all patients available and eligible for that trial and make sure they stay on the trial. So for me the other big challenge is to engage with patients and patient groups early on.’
Willie Muelhausen - Head of Innovation at CRO ICON
'The number one challenge to everyone in the industry is patient recruitment...as we all know, we don't have enough patients. Sites quite often don't recruit enough patients - 11% of sites don't recruit a single patient into a trial. At the same time we spend billions of dollars on patient recruitment initiatives within the industry. So if we can tackle that and make it easier for patients to be on clinical trials, that would be a key improvement…’
‘Only 1% or 2%, depending on whether you're in Europe or the US, of patients know about trials, that participating in clinical trials in an option.
The other thing we want to do is make it easier for patients to join a clinical trial. Technology can help with that - eConsent is one example where we can tell patients in a more comprehensive way, but also in an easier way to comprehend what it is that they're signing up for.
We can also help sites to find the right patients. We would for example do pre-screening based on the patient records that they have to help them to find the right patients. On that same topic, protocols are getting more and more complex - in the last 10 years they've gone from 110 procedures per protocol to like 160 or 170 procedures.’
'I think there are a couple of ways Sponsors can improve recruitment. One of the key things is around awareness - they need to make more noise around trials and what the benefits are for a patient. And we need to find out what it is that makes patients drop out...Once we have more knowledge around that then we can changes the processes.’
Matt Cooper - Business Development and Marketing Director at NIHR Clinical Research Network
'With the greater level of personalisation of medicine and the trials related to them, it's finding the right patients for those trials, particularly in those niche or rare disease areas. In England in the NHS, we've got great services around those rare areas and it's really about making sure that we can target the trials to those right individuals.'
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