Decentralised and hybrid trials

Listening to the patient

Decentralised and hybrid trials are widely discussed in the pharmaceutical industry and are already being deployed on some clinical studies. There are organisations that are convinced that it is the next big step in making clinical research more patient-centric and that this will have a significant impact on the ongoing challenge of patient recruitment.  But what does the patient think? 

ICON conducted a survey through its Global Site Network to get the patient view and find out whether bringing the trial to the patient could make a difference in accessing more patients. We explored perceptions and preferences around what makes it easier for patients to participate in clinical trials and to determine whether industry perception was reality.

The majority of patients indicated hybrid or no preference on where clinical trial test are taken

Key insights

• Patients want options.  Decentralised trials are attractive to some but not all patients in the survey. Hybrid trials are more likely to be of interest because the attachment with the healthcare professional and the support they provide remains intact. 
• The patient relationship with site staff is important.  In fact, since all of the patients involved in this study were connected with a site, whether that was through participation in a trial or just screening, this may have had an impact on how patients surveyed responded to some questions.
• Although patients are open to the idea of virtual trials with video calls, they still prefer face-to-face interaction for some or all visits.  
• While decentralised trials are appealing to some, travelling to a site is not a major barrier to all. Patients are willing to travel in order to have the opportunity to participate in a clinical trial.
• Patients prefer non-paper options for diaries, but the option of devices needs to be available for those who do not want to use their own or do not have them.
• Differences are not as pronounced in therapeutic areas as might be predicted. However, there were some therapeutic areas that showed more enthusiasm for decentralised or hybrid trials.  For example respondents with Dermatology conditions consistently demonstrated a tendency to prefer or be open to remote options and had the highest preference to use their own smart phone. Neurology patients showed similar tendencies.
• Age considerations cannot be taken for granted. When looking further at the data within specific age groups, the 18–24-year-old group tended to prefer on-site, face-to-face interaction while the 25–34-year-old group was the most open to remote visits and activities, with a steady decline thereafter with increasing age.
• The provision of free services for coordinating travel arrangements or other logistics was important for all age groups in making them more likely to consider participation in a clinical trial.

Conclusion

• The industry, sponsors and sites need to connect and align with the patient needs if they really want to improve the patient experience and make the clinical trial truly patient-centric.
• The patient perspective on clinical trial participation may differ from what is generally expected at an industry level.  We need to ask the patients what they want, provide choices for them, and move at their pace. Moving too quickly, increasing the challenges and complexities of participation may mean slower adoption in the long run.

Contact us today for more information on this survey, our patient insight program or to discuss our decentralised and hybrid services.