As reported on Pharmalot (here): "Last year, Pfizer announced plans to run the first clinical trial to allow patients to participate from home by using computers and smartphones instead of going to a clinic or doctor’s office. The idea was to create a model for saving money that will rely on personal technology to more easily recruit patients and monitor their progress. Known as a ‘clinical trial in a box,’ the study is testing the Detrol overactive bladder drug in 10 states and gained an FDA blessing. However, Pfizer ran into some snags winning over patients."
Craig Lipset, Head of Clinical Innovation at Pfizer, explained it this way: "I think some of the staunch advocates for using online and social media for recruitment are still reticent to claim silver bullet status and not use conventional channels in parallel. In terms of health literacy, the patient population is largely unaware of clinical trials and participation. You’re going in at a level where there’s still a lot of basic learning needed for individuals to make informed decisions about whether to participate. And doing that without an interaction with a healthcare provider is a challenge."
I wouldn't say there's a lack of "health literacy" regarding decisions to participate, but more lack of credible information and TRUST, which is what Lipset is talking about in the last two sentences quoted above.
As Lipset admits later on in the interview with Pharmalot:
"In a world where we’ve been telling people not to trust (web) sites online and then to ask them to do everything online is still a challenge. A very important takeaway is that online is great, but make sure these folks know they’re not alone and have a sense of contact that they need… The twist here was to go from awareness to randomized participant entirely online, and this is where ensuring some human contact as well as an optimized online process have proven extremely important."
Is this a case of the "dead rat" coming home to roost? See "Was a Rat Harmed in the Filming of This Pfizer Commercial?"
@pharmaguy 75% have little to no knowledge about clinical trial participation (trust is important, but education is a key barrier) http://www.ciscrp.org/professional/facts_pat.html - @craiglipset
ReplyDeleteCraig,
DeleteThanks for responding to my post and your link to CISCRP. There appears to be a lot of information there, but that is the problem -- too much information that requires reading. I consider myself a literate person, but in this day and age, there needs to be more to education than just brochures and such. Who has the time to read that stuff?
Patients want to go to doctors and have a face-to-face discussion about clinical trials and get their information that way. Certainly technology can help provide that kind of interaction via the Internet.
Look at Rosetta Stone and how they teach languages. There are pictures and audio and I can schedule a live video chat session with an expert! What a great learning experience!
Anyway, my two cents for what it's worth.
John
Hi, John.
DeleteThe CISCRP data tells us that most patients are simply unaware of clinical trials or how to go about participating.
While it would be ideal for doctors to have a discussion about clinical trials with patients, data reveals that only 7% of Americans report ever having a doctor suggest clinical trial participation.
The reason lies in the fact that fewer than 4% of US physicians participate in research. For the 96% that do not participate, there are very few incentives for them to suggest referring their patient to another doctor to participate in their study. We do not pay for referrals (inducement) and in a fee-for-service healthcare system the incentives otherwise do not exist.
Fixing those incentives is one of the 'pearls' of the study referenced above -- enabling a treating physician to have their patient participate in a trial without fear of losing that patient to another doctor.
- @craiglipset
Craig,
DeleteIt's a tough problem, I admit.
BTW, this would be a great topic to present at Doctors 2.0 conference in Paris in May (http://www.doctors20.com/) -- I also invite you to call in to my LIVE podcast interview tomorrow at 11 AM (Easter US) with Denise Silber, the conference organizer (http://www.talk.pharma-mkting.com/show161.htm). The topic will be "Can New Technologies Improve Healthcare? Exploring the 2.0 Doctor." The number to call is: (347) 996-5894. I'll be happy to put you "on the air" live. Call a few minutes prior to the show and I can introduce you as a guest -- or call during the show and press "1" to ask a question, make a statement, or participate in the discussion.