Polhemus Ashley M, Kadhim Hassan, Barnes Shelly, Zebrowski Susan E, Simmonds Alex, Masand Shirley N, Banner Jaclyn, Dupont Melissa
1 MSD Global IT Innovation Center, Merck, Sharpe & Dohme Corp, Prague, Czech Republic.
2 IT Clinical Trial Planning & Management, Boehringer Ingelheim, Ridgefield, CT, USA.
Ther Innov Regul Sci. 2019 Jan;53(1):8-24. doi: 10.1177/2168479018801566. Epub 2018 Oct 29.
Patient-facing digital technologies (also called "Patient Technology" [PT]) have the potential to serve a variety of functions in clinical trials, such as capturing clinical endpoints, engaging patients, and facilitating remote study conduct. However, these technologies are not yet accepted as mainstream research tools, and the opportunities, challenges, and facilitators associated with their implementation in clinical trials have not been fully characterized.
In order to understand the factors affecting PT adoption, the TransCelerate Patient Technology Initiative conducted a series of surveys, interviews, and focus groups with approximately 600 subject matter experts, including pharmaceutical company representatives, clinical trial investigators at a number of trial sites worldwide, and clinical trial participants. All interview and survey responses were blinded and aggregated by a third-party consultant and themes were extracted.
There was general consensus around the potential value of patient-facing technology as a clinical research tool, though a variety of challenges faced by each stakeholder were discussed. Detailed accounts of opportunities (improved patient experience, compliance, and engagement; clinical trial efficiencies; improved data quality and insights) and barriers (organizational and corporate cultural challenges, business-related challenges, user willingness and burden, and regulatory challenges) are reported.
While the barriers to PT adoption explored here were numerous, they were also generally consistent. A number of proposals for establishing more holistic, collaborative, and strategic approaches to PT implementation in clinical trials are discussed. Such approaches could facilitate more effective, widespread adoption of PT, and thereby a more patient-centric clinical trial paradigm.
面向患者的数字技术(也称为“患者技术”[PT])在临床试验中具有发挥多种功能的潜力,例如捕获临床终点、吸引患者参与以及促进远程研究开展。然而,这些技术尚未被接受为主流研究工具,并且与其在临床试验中实施相关的机遇、挑战和促进因素尚未得到充分描述。
为了了解影响患者技术采用的因素,加速转化患者技术倡议组织开展了一系列调查、访谈和焦点小组讨论,参与对象约有600名主题专家,包括制药公司代表、全球多个试验地点的临床试验研究者以及临床试验参与者。所有访谈和调查回复均进行了盲化处理,并由第三方顾问进行汇总,然后提取主题。
尽管讨论了各利益相关方面临的各种挑战,但对于面向患者的技术作为临床研究工具的潜在价值存在普遍共识。报告了机遇(改善患者体验、依从性和参与度;提高临床试验效率;提升数据质量和洞察力)和障碍(组织和企业文化挑战、业务相关挑战、用户意愿和负担以及监管挑战)的详细情况。
虽然此处探讨的患者技术采用障碍众多,但它们也普遍具有一致性。讨论了一些关于在临床试验中建立更全面、协作和战略化的患者技术实施方法的提议。此类方法可以促进患者技术更有效、广泛的采用,从而形成更以患者为中心的临床试验模式。