Technology in Clinical Trials #2 – Telemedicine, Digital Solutions, and Patient Engagement

Time flies and it has been a month since my last newsletter! I am really pleased with the engagement my first newsletter has gotten and I appreciate all the messages sent by readers.

In this edition of Technology in Clinical Trials, we explore the other recurring themes of the newsletter - telemedicine, digital solutions, and innovative approaches to patient engagement & recruitment.

?? What is Telemedicine?

As defined by Haleem A et al, telemedicine is a "health-related service with the help of telecommunicating and electronic information technologies". It encompasses various solutions aimed at facilitating communication between patients and their doctors (study doctors in the case of clinical trials) or healthcare providers. Telemedicine encompasses various applications such as virtual patient consultations, telemedicine nursing, remote monitoring, and teletherapy for physical and psychiatric rehabilitation.

Below is a summary of an article highlighting the benefits of utilizing telemedicine and the potential it has to transform clinical research practice:

[Article - Commentary] How Telemedicine Can Transform Clinical Research and Practice, co-authored by Anne Chiang and Roy S. Herbst, highlights the benefits that telemedicine brings to both patients and healthcare professionals, paving the way for a more efficient and patient-centric approach to clinical research and practice. The utilization of "telemedicine in clinical research enables the recruitment of a more diverse patient population" through increased accessibility, reduces the burden of in-person visits, and enhances patient convenience by allowing patients to participate from their homes. Chiang and Herbst also discuss the challenges associated with telemedicine implementation, such as infrastructure requirements, data privacy and security, and reimbursement considerations. Overall, the commentary emphasizes that telemedicine has enormous potential to transform and improve clinical research and practice by increasing patient engagement, expanding access to care, and streamlining research processes.

?? What are Digital Solutions?

In short, a digital solution is an automated approach to accomplishing a task that would typically require a different, often slower, and more time-consuming method.

In the context of clinical trials, digital solutions are becoming an increasingly attractive means of reducing costs and improving trial efficiency, effectiveness, and accessibility, with both investigators and patients appreciating the benefits.

[Workshop Proceeding] One of the key highlights from Transforming Clinical Trials with Technology mentioned by Karl Kieburtz is that new advancements like "wearable devices, remote monitoring, and virtual clinical visits have the potential to make clinical trials more patient-centric". He predicts a significant change in the current model of conducting clinical trials, moving away from dispersed locations to a central focus or single center. In this future model, investigators (from academia, industry, or foundations) would directly engage with patients and families to initiate trials, while assessments would be conducted remotely or through telemedicine. However, Kieburtz also acknowledged that multi-site studies face an additional challenge of considering regional and cultural variations and their impact on outcomes. Carlos Rodarte further commented that clinical trials exploring, for example, interventions for mood disorders need to account for geographical differences in sunlight exposure and physical activity which might affect the response of patients in sunny versus cold regions.

???? Innovative Approaches to Patient Engagement

With the growing complexity of clinical trial protocol designs and increasingly limited eligible patient populations, the recruitment and retention of participants throughout trials is becoming more challenging.

Clinical research organizations and clinical care professionals are introducing a variety of technologies and other services (for example, decentralized trials) aimed at improving the recruitment of diverse participant populations and retaining them for the full study duration.

A novel approach (that emerged during the pandemic) is to identify and recruit patients via social media platforms.

[Article - Review] Darmawan et al examined The Role of Social Media in Enhancing Clinical Trial Recruitment. The review identified 33 studies that reported using social media and traditional methods in clinical trial recruitment. The most commonly used social media platform was Facebook, followed by Twitter. Traditional methods included print, in-person venues, and referrals from healthcare professionals. The review also examined the enrollment rates and costs associated with recruiting participants for clinical trials through social media and traditional methods. The enrollment rates from social media ranged from 2% to 86%, while the enrollment rates from traditional methods ranged from 2% to 100%. Some studies reported higher enrollment rates from social media compared to traditional methods. The review also found that social media can be an effective tool for recruiting participants for clinical trials, particularly for lifestyle-related interventions. Furthermore, the costs per enrolled participant varied depending on the recruitment type. For social media, the costs ranged from N/A to US?$1426, while for traditional methods, the costs ranged from US?$5.27 to US?$2141. Overall, the findings suggest that social media can be an effective tool for recruiting participants for clinical trials, with varying enrollment rates and costs compared to traditional methods. However, further research is needed to fully understand the advantages and disadvantages of using social media for clinical trial recruitment.

What's next?

In the upcoming editions of Technology in Clinical Trials, I will share insights on recent publications and materials in the key focus areas of the newsletter (artificial intelligence, digital solutions, patient engagement, and telemedicine). Stay tuned!

? Disclosure statement ?

Lastly, I would like to point out that I am NOT associated with and am NOT sponsored by any of the groups or organizations I refer to in this edition of the newsletter.