CROs facing formidable challenges in clinical research: survey

By Jenni Spinner contact

- Last updated on GMT

(D3Damon/iStock via Getty Images Plus)
(D3Damon/iStock via Getty Images Plus)

Related tags: Clinical trials, COVID-19, patient engagement, Patient centricity, Clinical research, CRO

Conducted by patient services specialist Greenphire, the survey checks in with contract research organizations and shows how they are approaching obstacles.

Thanks to the unprecedented interruptions and obstacles created by the COVID-19 pandemic, rapid technological evolution, and increasing pressure to accelerate research, contract research organizations (CROs) are facing more obstacles and complexity than ever before.

A recent industry survey from patient services firm Greenphire checked in with CROs to gauge how they’re weathering all these challenges, and what tools they’re turning to in order to improve their patient engagement, site satisfaction, and other metrics. The survey (conducted in July and August) yielded responses from 168 professionals representing both large and small companies, covering a variety of therapeutic areas, and from different geographical regions.

Wayne Baker, chief commercial officer of Greenphire, discussed the survey with Outsourcing-Pharma, offering insight into the minds of CROs and what the responses might reveal about the future of clinical research.

OSP: Please share some insight as to why you decided to put out this survey—what did you hope to learn or determine from the responses?

WB: This is our second year distributing this survey. Last year, we wanted to understand firsthand from sponsors and CROs the impact COVID had on their businesses and what solutions they were putting in place to help sites and patients as they un-paused studies.

This year we wanted to compare last year’s results and see what is different. Is technology still as much of a priority investment for sponsors and CROs? Geographically, we wanted to validate that patient engagement services are a global priority for recruitment and retention. We also wanted to understand what sponsors and CROs think is most important when positioning themselves as a sponsor of choice to their site partners.

We also use this information to funnel back to our product team, so they are aligning their innovation plans with industry trends and site preferences.

OSP: How did you pinpoint the industry people you were going to ask to respond?

WB: In order to cultivate the list we used our client and prospect lists so we had a broad spectrum of invitees for the survey. We also invited the individuals tuning into our July webinar on Recruitment and Retention in July to take the survey.

OSP: What kinds of questions did you end up including?

WB: This year’s questions centered largely on patient engagement goals, technology, and current obstacles:

  • Demographic questions such as what country they were in (52% global), if they were a sponsor / CRO, what their role is (64% ClinOps)
    • Regarding the impact of patient engagement technology on recruitment and retention
    • The urgency of removing patient financial and logistical barriers now vs. before the COVID-19 pandemic
    • Regarding the preference for decentralized trial technology
    • Diversity goals
  • Being seen as a sponsor of choice and how to accomplish that
  • Current obstacles (resources, costs, etc.)

OSP: Please share some of the most notable findings.

WB: Here they are:

  • 97% of responders said that “providing technology solutions for patient engagement in clinical trials can positively impact recruitment and retention​.”
  • 87% of responders said that “removing financial and logistical barriers that could deter patients from participating in clinical trials is more important now than it was before the COVID-19 pandemic.”
  • 73% of responders agreed with the following “Our organization is actively seeing to increase the use of technology to better support decentralized trials.”
  • 71% of responders agreed with the following “For the studies that I am a part of, it is a goal to increase the diversity of underrepresented populations (ethnic backgrounds, socioeconomic levels, and more) among clinical trial participants​.”
  • 95% of organizations want to be perceived as a sponsor/CRO of choice; providing patient convenience solutions such as reimbursement and travel support, and streamlining site payments and invoicing were the top methods of how sponsors/CROs can foster enhanced relationships with sites.

OSP:  Were there any surprises?

Wayne Baker, chief commercial officer, Greenphire

WB: Yes; for example, responders outside of the US are just as committed to patient engagement technology as those in the US. We asked if sponsors and CROs agreed with the following statement, and 98% of US respondents agreed, and 96% of those outside the US agreed. Providing technology solutions for patient engagement can have a positive impact on patient recruitment and retention.

Sometimes we hear that technology isn’t as prevalent or desired outside of the US. This data validated that these investments in the patient experience are valued nearly equally all around the world.

Also, decentralized/hybrid technology is here to stay. Just 7% of survey responders said that “decentralized trial technology is not as important now as we’re moving past the COVID-19 pandemic.” There has been much discussion over the past year of “no going back” to the manual and less digital methods of operating clinical trials, and that desire seems to have persisted.

Additionally, resources to implement new initiatives are a challenge. Both sponsors and CROs emphatically agreed that “resources (people, time) to implement new initiatives are a challenge at this point in time. (Interestingly, CROs were 10% more likely to cite resources being a challenge)

Leveraging resources through service providers can remove resource strain internally, opening up the organization to pursue deeper patient-centric initiatives needed to enable improved recruitment and retention, and overall study success.

Headcount is also a global challenge – whether it be in clinical research or in other industries. Ongoing stress and anxiety from the global pandemic weigh on workers, and employers are struggling to fill open requisitions.

OSP: There are some differences in what CROs indicated on some responses, and what sponsors answered. Could you please share your thoughts on why the differences?

WB: CROs can be an effective partner in helping sponsors execute their global research studies. As this audience looks to differentiate their services against other CROs and meet the needs of sponsors with whom they work, we see that CROs are making deeper investments in patient engagement solutions to improve retention and enhance relationships with clinical research sites.

According to the SCRS Site Landscape Survey (2020), research sites prefer to be paid monthly by their partners, especially now when their operating capital has been drastically impacted by COVID. Overall, the SCRS reports that sponsors and CROs are feeling as though sponsors and CROs are treating them as more of a partner than in previous years.

Some CRO-related responses and insights:

  • 36% of the total responders were CROs
  • 97% of CROs agreed with this statement (vs. 96% of sponsors): “Providing technology solutions for patient engagement in clinical trials can positively impact recruitment and retention​.”
  • 88% of CROs agreed with this statement (vs. 87% sponsors): “Removing financial and logistical barriers that could deter patients from participating in clinical trials is more important now than it was before the COVID-19 pandemic​.”
  • CROs vs. sponsors responded more emphatically that “Decentralized trial technology is an important method to deliver patient-centric services now and in the future​.”
    • 75% of CROs vs. 64% of sponsors selected this response.
    • 90% of CROs (vs. 63% of sponsors) agreed with this statement: “Our organization is actively seeking to increase the use of technology to support decentralized trial​s”; either CROs see this as more of a priority now, or were under-using technology prior to the pandemic.
    • CROs responded more strongly to a question re: diversity. 78% of CROs vs. 68% of sponsors agreed with this statement: “For the studies that I am a part of, it is a goal to increase the diversity of underrepresented populations (ethnic backgrounds, socioeconomic levels, and more) among clinical trial participants.
    • 98% of CROs agreed with this statement: It is important that our organization is perceived as a sponsor/CRO of choice amongst sites. (vs. 94% sponsors)
    • We asked how sponsors/CROs can foster enhanced relationships with sites. CRO responders were more likely to say “streamline site payments and invoicing” whereas sponsors responded “provide patient convenience solutions such as patient reimbursement and travel support” as their first choice.
    • Top obstacles faced by CROs right now: #1 selection: Resources (people, time) to implement new initiatives. 64% of CROs cited this vs. 52% of sponsors.

OSP: Please share some general thoughts on what the responses say about the future direction of clinical research.

WB: It absolutely confirms the industry’s commitment to patient engagement, and that there is demonstrable ROI in the form of improved recruitment and retention. It also demonstrates that hybrid trial trends are here to stay, whether COVID is here or not. Virtual visit technology, micropayments, and more are all ways that sponsors can provide flexible patient support models on a global scale.

OSP: What do you think or hope CROs and sponsors, and other industry folks, might take away from the survey results?

WB: I hope that sponsors and CROs will leverage this survey data in building their own business cases for patient engagement, so they may benchmark their patient engagement programs against other industry peers.

OSP: Do you have anything to add?

WB: Greenphire is committed to providing global patient engagement services to remove patient burden – whether it be logistical or financial, as well as making it easy for sponsors and CROs to have a single partner to execute on these important clinical research strategic initiatives. By working with Greenphire, sponsors and CROs can be a preferred global partner to clinical research sites and the patients they work with.

The time needed for clinical research visits and the transportation required are the top burden experienced by research participants, and our solutions make these decisions and investments that much easier, enabling participants to stay in studies for the full duration.

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