Simulating clinical trial visits yields patient insights into study design and recruitment

• Type of Material: Article
• Authors: S Sam Lim, Emory University; Alan J Kivitz, Altoona Center for Clinical Research; Doug McKinnell, Deloitte Life Sciences Advisory; M Edward Pierson, AstraZeneca; Faye S O'Brien, AstraZeneca
• Language: English
• Date: 2017-01-01
• Publisher: Dove Medical Press
• Publication Version: Final Published Version
• Copyright Statement: © 2017 Lim et al.
• License: Creative Commons Attribution-Noncommercial 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.2147/PPA.S137416
• Title of Journal or Parent Work: Patient Preference and Adherence
• ISSN: 1177-889X
• Volume: 11
• Start Page: 1295
• End Page: 1307
• Grant/Funding Information: Study support was funded by AstraZeneca.
• Keywords: PREVALENCE; General & Internal Medicine; Science & Technology; RECEPTOR MONOCLONAL-ANTIBODY; SYSTEMIC-LUPUS-ERYTHEMATOSUS; systemic lupus erythematosus; Medicine, General & Internal; lupus nephritis; patient retention; OUTCOMES; patient recruitment; MULTICENTER; clinical trial simulation; Life Sciences & Biomedicine; PARTICIPATION; UK FUNDING AGENCIES
• Research Categories: Health Sciences, Health Care Management; Health Sciences, General

Abstract

Purpose: We elicited patient experiences from clinical trial simulations to aid in future trial development and to improve patient recruitment and retention. Patients and methods: Two simulations of draft Phase II and Phase III anifrolumab studies for systemic lupus erythematosus (SLE)/lupus nephritis (LN) were performed involving African-American patients from Grady Hospital, an indigent care hospital in Atlanta, GA, USA, and white patients from Altoona Arthritis and Osteoporosis Center in Altoona, PA, USA. The clinical trial simulation included an informed consent procedure, a mock screening visit, a mock dosing visit, and a debriefing period for patients and staff. Patients and staff were interviewed to obtain sentiments and perceptions related to the simulated visits. Results: The Atlanta study involved 6 African-American patients (5 female) aged 27–60 years with moderate to severe SLE/LN. The Altoona study involved 12 white females aged 32–75 years with mild to moderate SLE/LN. Patient experiences had an impact on four patient-centric care domains: 1) information, communication, and education; 2) responsiveness to needs; 3) access to care; and 4) coordination of care; and continuity and transition. Patients in both studies desired background material, knowledgeable staff, family and friend support, personal results, comfortable settings, shorter wait times, and greater scheduling flexibility. Compared with the Altoona study patients, Atlanta study patients reported greater preferences for information from the Internet, need for strong community and online support, difficulties in discussing SLE, emphasis on transportation and child care help during the visits, and concerns related to financial matters; and they placed greater importance on time commitment, understanding of potential personal benefit, trust, and confidentiality of patient data as factors for participation. Using these results, we present recommendations to improve study procedures to increase retention, recruitment, and compliance for clinical trials. Conclusion: Insights from these two studies can be applied to the development and implementation of future clinical trials to improve patient recruitment, retention, compliance, and advocacy.