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Patient Recruitment Changes Revealed as Trials Industry Reunites

by Imogen Cheese
Patient Recruitment Changes Revealed as Trials Industry Reunites

When you’ve had to wait 20 months to travel for work, you hold that first re-emergence into pre-pandemic day-to-day business activity on a high pedestal. Expectations are HIGH, and a quest for perfection sways with the giddy anticipation that once again you are actually getting on a plane destined for another country for work!

And therein ends my dream.

I had what can only be described as a bizarre week of work travel. It started with a brutal bump, but ended — thankfully — much, much better.

I shall share my weeklong torment for your amusement.

A delayed journey from England to Switzerland

The bump in question was a car accident (no, not mine). I was two cars behind, travelling along a winding country lane on my way to the train station to catch a train to the airport for my first of two flights en route to Switzerland.

The car accident took over an hour to clear, meaning I missed my train. I caught the next available option with the intention to contact (now I was back in the less rural areas of the U.K. actually covered with phone signal!) my airline to advise I would miss my check in. Could I catch the flight the following morning instead?

And so began 10 hours of stress.

Phone lines not answered. 24-hour WhatsApp/messenger communication options drawing a blank/not answered. Online flight change paths all providing a code and advising I contact an agent – none of whom were answering any calls.

It seems that Covid issues caused flight cancellation issues across Europe, so I was one amongst thousands desperately trying to speak to a person… and apparently, people who answer telephones are in short supply.

Eventually – with new flights and a changed hotel reservation (thankfully much easier to resolve than the flights!), I arrived in Zurich.

Imogen’s twisted journey leads to a productive conference in Zurich.

I arrive at my destination

My first stop was Outsourcing in Clinical Trials, DACH and Western Europe. This conference, organized by KP Morgan, brought together a varied mix of organizations based in and operating within the European Union to talk through all the hurdles faced in the industry at present.

The obvious highlight of this conference was catching up with friends and colleagues that I haven’t seen in almost two years, but it was a pleasure to hear some of the very well thought out talks. One of the talks was a fireside chat by Sotirios Perdikeas of Roche.

He noticed that over the last few years, there has been an increasing developing pattern to focus on recruiting. Whether recruiting in high numbers or within short timeframes, it has increased pressures on CROs. This pattern itself has been unrealistic, but as a result has had a knock-on detrimental effect on quality. To achieve recruitment, there have been sacrifices in quality checks.

Implementing clear key performance indicators and tracking specific data throughout helps keep the trial moving forward. Rather than halting at brick walls, trials and the teams managing them need to be more agile. As we have clearly seen with the pandemic, things can change very quickly.

There were, as you would expect, especially in the wake of Covid and the vaccine delivery,  great talks that covered decentralized trials, the more adaptive hybrid trial solutions.

Trials meet today’s realities

One great talk in this area that resonated with me was a talk about modernizing trial conduct by Natalia Monteiro of Frontier. She said an interesting change we will see over the next couple of years is an increase in studies for rare disease areas. Whereas previously low numbers made trials in these indications cost and logistically prohibitive, decentralized trial design opens up doors, giving us a chance to change what normal parameters are.

As we move our trial design, we face new hurdles – the issues now become more global and more complex:

  • How many different systems are we having to learn how to use?
  • How many passwords and login details do our teams need to remember?
  • Who owns the data? What regulatory governance is the data being gathered and stored under?
  • What software or e-platform is being used, and will the technology change?
  • Can we still review, access, and manage that data in 25 years’ time?

Effectively, we have more weapons in our arsenal. But the rules of the game have changed, and they are still changing. We need to plan our studies for now and the instantaneous data the trial generates – and also for what we might still need to know or learn from our studies in 5-10 years’ time, or more!

A speaker at a roundtable discussion said we should think of our patients and their experience in the study as a consumer grade experience. What does the patient want, what will help them, what do they think of our company based on the information we share with them and how we share it?

Meeting key clients

The following day, I met with two of my favorite clients. It was so good to finally get to catch up with them face-to-face rather than over Zoom, although conference room limits in one meeting meant a video call was still required for some!

And interestingly, the consumer grade experience was very much in mind when I met with my clients. First with Imperial tailoring a print on demand solution to meet the very unique needs of our client to ensure the information that they provided the sites and in turn the patients was customized for each site. And then with my second client, supporting their global study with a patient engagement care package that has the wow factor, both outside and inside the box!

The legacy of our solutions provides comfort and reassurance for patients, alleviates stress, and helps support the role of the site teams. In turn, recruitment is easier, quicker, and more cost effective. Most importantly for both of these clients, they have not sacrificed quality.

And quality, or the feeling of quality, is my overriding take home from my experience in Switzerland – the immaculate, cost effective double-story efficient trains, the delightful “fast food” cooked in front of you to warm you up as you meandered through Christmas markets, and of course, the chocolate, which I seem to have bought a lot of… for Christmas and medicinal purposes only, of course!

If mask wearing and complicated travel is the new normal, then I shall adapt. The opportunity to see clients and friends in the industry is worth it!

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