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Let’s talk about recruitment and retention
Have you found the “Sweet Spot”?

A ‘patient-centric trial’ is not a new bandwagon for consultants and service providers to try to sell the same old solution, repackaged. It is an important approach to clinical trial design that is essential in improving patient recruitment and retention long term.

The clinical research environment is facing chronic, yet accelerating, erosion in the number of patients taking part in and remaining in clinical trials. In addition, fewer physicians want to take part in clinical research, fewer patients seem to be attracted to trials, and trials remain unlikely to complete on time. So, this is not a bandwagon – this is a real problem.


What makes a trial patient-centric?

This approach places the patient experience at its core. The idea is to encourage everyone involved to think about what it is like to participate in the clinical trial from a patient’s perspective.

Of course, the patient has always been considered as a stakeholder, as they stand to benefit medically. But do they really? Recruited patients may get the comparator or placebo drug, they could experience serious side effects, or they may have poor access to the drug after the trial. Patients may not be able to get the tested drug when it is on the market, because it is too expensive or it does not launch in their own country. To top it off, patients have to visit the clinical trial site constantly – much more than in the course of normal, therapeutic treatment.

The idea that a trial provides a chance of improving the patient’s health is not enough to call a trial patient-centric.  Rather, a patient-centric trial needs to recognize that the patient is voluntarily participating in the trial and needs to minimize the impact of the trial on their life. 

Where are we now?

While this concept grows we have seen some strides towards building more patient-centric trials with the surge of mobile and wearable devices hitting the market and entering the clinical trial world. In addition, some Sponsors are taking it to the next level by offering complete remote, virtual trials. In addition to this, we have seen a number of Sponsors include patient groups in their product and protocol design.


Including the voice of the patient gives insight to the life of the clinical trial participants and the end user of the approved drug or device.


The industry continues to march down the path of patient-centricity and even focuses large events such as Patients as Partners (this year in London and Philadelphia) concentrating on bringing the patient to the table throughout the entire medicine development process and life cycle.

While the industry tries to move away from site-centric or sponsor-centric trials, the virtual model and wearables that work for some studies don’t work for all.  Complex protocols with visits that include specialized equipment, complex treatment, or the need for a specialized trained nurse or physician leave sponsor, site, and patients with no other choice than conducting the visit at the site.

In addition to complex visits inhibiting the adoption of patient-centric tactics, there are also the concerns that have been raised by sites. Principle Investigators have expressed that they have a lack of oversight of their patients which leads to concerns about accountability.  Limited interactions with patients doesn’t work for all physicians – an opinion that is incredibly important in this process.

So where is the middle ground and how does MRN fit into all of this?


We’ve found the “Sweet Spot” - driving benefits for patients, sites and sponsors.  In particular, “patient-centric” sits right upstream of the others in the process flow, so benefits for the patients will also be felt downstream, benefiting the sites with more participation and money and the sponsor with faster trials.


MRN’s centricities

 MRN strives to make clinical trials easier, with the premise that easier means faster, more efficient and higher quality.  The ethos of MRN is about addressing the root cause of problems, not the symptoms alone.

Home trial support allows us to conduct a percentage of the trial visits in the patient’s own home. The impact of the trial is massively reduced for the patient (and their family or caregiver) and patients love this.  Simultaneously this makes the trial available to a much wider and more geographically dispersed patient population.

Site nurse support is site-centric. By providing the resources and expertise the sites need this allows sites to take part in trials they otherwise might not have been considered for.

Posted by:
Laura Lange
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