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How can digital technology enhance patient engagement in clinical trials?


It’s no secret that the research industry faces many challenges when it comes to recruiting and retaining patients for clinical trials. Results show that 85% fail to recruit enough patients, 80% fail to finish on time, and there’s a 30% average drop-out rate.* Fortunately, opportunities exist to overcome these issues, such as patient engagement apps to improve enrolment and retention in clinical studies.


Rising the retention rate with patient engagement

Patient retention is vital for the success of a clinical trial, yet it’s often a factor that gets overlooked once the research team have finally recruited their target patients. The truth is, even if a patient agrees to take part in the study, nothing is stopping them from leaving. After all, they have the right to withdraw at any time.


The key is to design a study that makes the patient want to stay for reasons that benefit themselves, and one that provides the support and guidance they need throughout the trial. This is where patient engagement comes in. Higher levels of compliance and retention can be achieved if patients are supported throughout a study, and continuous engagement can help to achieve this.


Understanding patient drop out

The first step to addressing the retention issue is to understand the reasons why patients withdraw from a study. Many factors can play a role in a patient’s decision, but some common reasons include*:

Some of the reasons that patients leave a clinical study may be inevitable. However, there are some that we can try to prevent from happening, by getting creative.


Going digital and improving patient engagement

Using digital technology and medical apps to engage with patients is becoming increasingly popular. For example, Electronic Clinical Outcome Assessments (eCOA) is one of the fastest growing digital patient engagement tools used in clinical studies today.

Traditionally, clinical outcome assessments (COAs) – the process of measuring a patient’s symptoms, overall mental state, and the effects of their condition – were developed for completion via pen and paper. However, in recent years, the patient-centricity movement and the need for more personalised engagement has revolutionised this process, and we have seen an increase in electronic data collection instead.


A growing number of clinical trial stakeholders now consider eCOAs as the most effective way to capture high-quality, reliable data compared to paper-based methods. eCOAs employ the use of technology such as handheld devices, tablets or web to allow patients, clinicians and caregivers to directly report health outcomes, resulting in a more engaging service and better endpoint data.


There are different types of eCOAs:


The benefits

In addition to collecting the different types of reported health outcomes via an electronic device, using an eCOA tool also provides a communication platform for improved patient engagement throughout the trial. Healthcare professionals, patients and caregivers not only have access to the health reports, but a tailored communication plan, too.

Personalised and engaging


The eCOA tool can allow patients to receive relevant messaging through text messages, email and/or in-app notifications. For example, prompting them to take their medication and attend site visits. They’re able to have 24/7 mobile access to all the essentials: their health reports, site visit guidance, videos, study news and more. This allows them to track their progress throughout the study and their experience becomes more targeted to their needs.


Increased interaction

It has also been found that eCOA tools improve the interaction between patients and their clinician, and patients are more likely to discuss their symptoms at their site visit*:

The onsite team can also receive alerts that could enable early detection for potential patient safety concerns, as key risk indicators can be pre-configured onto the device, allowing the team to intervene and take corrective action when needed. They can communicate with their patients, and let them know if any data has been inputted incorrectly.


Increased efficiency and compliance

In terms of efficiency, the direct input of data onto an electronic device and a tailored communication plan saves both time and cost. It saves time printing, interpreting and transcribing the data, and reduces human error during data input. Having access to 24/7 guidance and receiving notifications and alerts can enable a shorter study timeline, a more personalised experience and higher engagement throughout the trial. As a result, the use of eCOAs increases compliance and retention.


Results show 94% compliance with eCOA, compared to 11% compliance with paper.*


Choosing the right technology

It’s important that the right digital device is used for each patient. With technology rapidly changing, eCOA applications must stay up-to-date with the newest devices to stay relevant for patients. The right technology not only improves active trial participation, but also improves the quality and accessibility of data collection.


The main methods for collection of eCOA data include computers, smartphones, tablets, as well as telephone systems. Some companies have even used ‘ePens’ that are provided to older patients who struggled with using their hands to report information on a tablet.

However, providing a tablet to record health information for each individual patient can be costly. Therefore, some are implementing a ‘bring your own device’ (BYOD) strategy to save costs and start-up time. Allowing patients to use their own device also increases compliance and engagement, as they feel it’s easier to use the device that they’re familiar with using. This can be made possible by developing apps that can be downloadable on any device for free.


Either way, the key is to choose the right technology for your target population to ensure a personalised and relevant experience, as well as recognising which technology will be most successful for collecting the specific types of data for your clinical study.


The key message

While recruiting participants for a clinical trial is challenging, keeping them engaged from start to finish is another hurdle that can’t be overlooked. By implementing eCOAs, and choosing the right technology, this provides benefits for patients, their caregivers and trial staff, allowing for a more personalised and engaging experience for the patient, which is likely to increase retention for the study.


Resources

  1. http://www.pharmafile.com/news/511225/clinical-trials-and-their-patients-rising-costs-and-how-stem-loss

  2. https://forteresearch.com/news/infographic/infographic-retention-in-clinical-trials-keeping-patients-on-protocols/

  3. https://www.ert.com/wp-content/uploads/2017/06/ERT_eCOA-Improves-Interaction_Clinical-Researcher_JUNE17.pdf

  4. https://www.ert.com/blog/what-is-ecoa-and-how-does-it-improve-clinical-trial-data-quality/

  5. https://www.ert.com/blog/improving-efficiencies-and-insights-to-clinical-trial-performance-through-ecoa-part-2-of-a-series/

  6. http://resources.rhoworld.com/blog/the-rise-of-electronic-clinical-outcome-assessments-ecoas-in-the-age-of-patient-centricity

  7. https://www.clinicalleader.com/doc/accelerating-clinical-trial-patient-engagement-retention-through-mobile-technology-0001

  8. http://www.appliedclinicaltrialsonline.com/improving-patient-engagement-through-ecoa?pageID=1

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