Clinical Trial Recruitment, Patient Demographics and Physician Education. Part 2 of an Interview with Beth Harper
What follows is part 2 and eventually part 3 of the interview I conducted with Beth Harper, CCO of Centerphase Solutions. You can find Part 1 and more about Beth and Centerphase here. In part 1 we discussed the general barriers to effectively and efficiently run clinical trials. Parts two and three are dedicated to clinical trial recruitment. We discuss recruitment tips, common misunderstandings and how clinical trial recruitment methods have and are continuing to change. Hope you enjoy Part 2, I’d love to hear what you thought so please comment below!
Part 2 – Patient Demographics and Physician Education
Kim: Different locations have different patient populations, not only race and ethnicity-wise, but also in terms of general disease demographics. For example, Harlem Hospital in New York City treats (in general) a particular demographic for a particular set of ailments, and Ashland Hospital in Ashland, Kansas sees a different set of people. To the best of my knowledge, there isn’t yet one single source that compiles information like this yet could be very beneficial in terms of targeting sites rich in patient populations that a particular clinical trials matches for. Does something like this exist that you know about?
Beth: This is complex question. Before we even get to that, finding sites that have the interest and motivation to be in research is a huge barrier. Many physicians are not exposed to research, they don’t get trained on it and so we don’t actually replenish and grow the pool of clinical trialists. If we don’t have the experts to run trials, then simply knowing where there are large pools of patients doesn’t really help the process because realistically those patients can’t be matched to an experienced investigator.
But with that said, patients exist everywhere. There may be pockets of higher prevalence patients with one disease or another, but essentially you can go to any city and find a patient with Alzheimer’s, a patient with Parkinson’s and a patient with breast cancer who want an alternative, who want to participate in a clinical trial. So to answer your question, I am not aware of a publically available master database (such as Clinicaltrials.gov for example) that links population rich areas with experienced investigators in those specific therapeutic areas or indications. There are a number of commercial vendors who do population density “heat maps” and marry those with lists of investigators who have conducted clinical trials but these are costly services. What you folks (TrialX) are doing is to let people know what is out there and where it is so we can minimize the logistical hurdle by matching patients to studies that are geographically proximate. But again, fundamentally, a lot of physicians do not get involved in research so patients interested in participating in trials have to research harder and travel further to find someone who might be ale to help them.
Kim: How can we educate physicians about clinical research, both to get involved in research and that particular trials are happening in their local area?
Beth: The challenge and dilemma we have is awareness building. Whether via new media forums like Facebook and Twitter or traditional media such as radio, print and advertising, patients believe in the information they are given from a trusted, credible source — from the physician or patient advocacy group for example. So we can have all the awareness building tools and tactics at our fingertips but if it doesn’t come from a credible source, it won’t work in terms of enhancing actual clinical trial participation.
Physicians have an obligation to let their patients know about different treatment options but if they don’t know about clinical trials, then they can’t educate their patients about them. Physicians have 2.2 minutes to see each patient and it is hard for them to keep up with all of the various treatment alternatives let alone clinical trial options. Often patients will hear about a clinical trial and then seek to validate the information form their trusted sources however the physician is often unaware of it themselves. So what we need is for the industry to put a little less attention on casting out the net into the public advertising for a specific clinical trial and balance that with a greater investment in physician education campaigns. At the larger societal level, we need to re-think medical school training programs and the investigator reimbursement process to ensure medical students not only get exposed to clinical trials but are appropriately incentivized to become clinical trialists once they graduate.