Interview: Tarquin Scadding-Hunt, CEO, mdgroup - the challenges of patient recruitment and retention
Getting the logistics right to support the process: What are the key challenges faced by patient recruitment and patient retention service providers?
We have entered a new era for clinical research. With the accelerated uptake of medical technologies and a more dynamic approach to trial design, decentralised and hybrid clinical trials are becoming more mainstream, providing remarkable opportunities for sponsors to put patients first in clinical research.
Multiple vendors and service providers are now involved in facilitating hybrid and decentralised clinical trials (DCTs), which poses new challenges for sponsors and contract research organisations (CROs). They must navigate the various processes and stakeholders involved to ensure trials run smoothly while ensuring they continue to remain fully compliant.
It will require time and whole-industry collaboration to tackle this effectively. The answers lie in better communications and a streamlined way of working to effectively manage the logistics of study conduct in this new era.
As experienced service providers, we can help sponsors, and CROs avoid costly mistakes and inefficiencies. Introducing new digital health technologies, such as travel management, patient payments systems and integrated apps, can also help remove some barriers to trial participation.
How can we boost the efficiency of patient identification for clinical research?
It is essential to help health and care professionals have a positive clinical research experience. They can become valuable advocates for research with patients and the public, educating widely and establishing a better understanding of the impact of clinical research. These professionals play a pivotal role in promoting participation in clinical trials, and we need to work together to enhance the experience for all.
What constitutes effective recruitment and retention strategies – what’s needed – what’s involved – how can that impact the patient?
Prioritising patient access and engagement is the only way to improve trial recruitment and retention. Technology allows us to reach more patients and streamline processes, but it should not be used in silos. Combining cutting-edge technology with white-glove, personalised patient care can significantly impact patient retention and engagement rates.
Similarly, we cannot rely on technology alone in the recruitment process. To create more diverse, accessible trials, we need to understand the needs of individuals and communities. We can only do that through effective communication, asking the right questions and listening to the answers. We need to build trust between patients and the healthcare and research sectors.
We develop all our products by listening to our clients and their patients’ needs. Our in-house technology platform, primarius patient, enables patients to submit and view their trial-related expense claims and to submit and view travel requests to attend trial visits. They can also view information related to their study, visits and how to access support. As part of our continued efforts to always put patients first, primarius patient can be accessed via a mobile and desktop app, giving patients control over their study experience in a way that works for them. It is also available in over 50 languages.
Our Ondemand service includes personalised concierge, travel, accommodation and expense support. To support and improve how patients interact with these services, we have enhanced primarius patient, making it even more straightforward.
The patient always comes first, and we must flex our solutions to meet their individual needs and continue to listen to the patient's voice as we evolve our products and services.
What blockers do you see still impacting recruitment and retention?
The uptake of decentralised solutions, even as part of a hybrid trial, is still quite low. Making them part of the study routine depends upon having the right processes and procedures in place and giving sponsors and investigators the confidence they need to adopt these new processes.
Part of the issue is that patient management strategies are only sometimes built into study protocols. This can lead to misalignments in the patient’s understanding and the trial’s expectations.
Participation in trials is a huge commitment, and it is often a struggle to fit study requirements around everyday activities such as work and family. Options such as mobile health, which allow visits to take place in the home and travel and expense reimbursement services to support patients when in-clinic visits are required help reduce the burden. Such services significantly reduce the inconvenience to patients and mean they are more likely to remain engaged in the study until the end.
Is the concept of diversity and inclusion being met? How can the industry better serve different patient populations?
To achieve fair and proportional representation in medical research, we need to ensure clinical trials are accessible.
Sufficient budget is often a barrier to patient engagement and diverse recruitment. However, we have seen that meeting the individual needs of patients leads to greater retention, which in turn results in time and resource savings in the long run. We must ensure research includes particular patient populations, even if they are difficult to reach. For example, we have helped people in refugee camps living with rare diseases participate in clinical trials.
Stakeholder Management for a seamless solution
Providing the right solution for the study is fundamental, as is providing remarkable patient care and preventing dropouts. This will ensure more effective outcomes, leading to higher returns in a shorter period.
When we build a better understanding of the available technology and services and the resulting data, sites become more willing to embrace these solutions. This, in turn, will enable CROs to present hybrid options to patients in a positive way.
mdgroup has also opened medical distribution centres in Europe and US to support our mobilehealth services, getting equipment to nurses and their teams safely and efficiently. These provide a single point of distribution for all items, including lab kits, centrifuges, ECG equipment and patient kits, which provide clients with better value costs and higher quality recalibration. Speed of response vital for our clients and their patients; we can ship the same day if required.
The key is education, collaboration with all stakeholders, and ensuring a streamlined workflow for all parties that offers the tracking and management needed for proper accountability and oversight.
Innovating for the Future: What do you see as the paradigm shift we can expect for R&D innovation, access and personalized medicine moving forward?
DCTs and hybrid trials are the future of clinical research, but only if we learn to embrace their benefits while avoiding their pitfalls.
The revolution will depend on how effectively patients, sponsors, sites, healthcare practitioners and medical distribution centres utilise technology platforms that underpin and connect all services, offering the participants options on how they carry out their trial experience.
We are developing technology that enables as many elements of a trial as possible to occur in the patient’s home without ever removing those all-important human interactions. We can take the trial to the patient or the patient to the trial, depending on the needs of each individual.
Using technology rather than paper to collect data has already led to considerable improvements in compliance and completeness of data sets. It is important to emphasise, though, that embracing technology does not, and should not, mean a loss of personal relationships.
Technological innovations should always put communication and patient engagement at the forefront of design. Work in this area is ongoing, and successful approaches will prioritise patient interest and access.