Virtual trials: Need of the hour?

Here’s another fascinating blog post from the BMJ blogs. Can the trials be extended to remote monitoring?

Here’s something that the authors have proposed:

Systematic reviews identifying barriers to clinical trials highlight that one factor in poor recruitment and retention rates are the burdens placed on participants through additional on-site appointments or procedures. [7,8] In-person visits may place financial, physical, and time pressures on individuals, leading to reduced participation and greater loss from follow up. [7,8]

A feasibility study of remote research visits in Parkinson’s Disease patients demonstrated high satisfaction with participation, and increased reported willingness and ability to participate in trials with remote data collection. [9] Ultimately this may present opportunities to make trial design more patient-centric. 

While virtual monitoring through wearable technologies may be a passive process, remote trials may require participants to play an active role in their own data collection. [10] This may not be intuitive for all sections of society, particularly those from a low socioeconomic background, as well as older individuals. These groups commonly have the most complex health needs and barriers to their participation and need to be considered carefully during protocol design to ensure virtual trials remain representative. 

Virtual trials: looking beyond covid-19 – The BMJ

The world isn’t fair. Cracking the “market” where these trials can be most cost effective, is the most difficult thing to do. Who foots the bill for the early trial interventions anyway? How do you assess the effectiveness? What will be the end goal? I am sure critics will point out that it is an attempt to keep out the population that would require hospitalisation! However, there are enough metrics to prove that traditional point of care is slowly shifting towards home care.

These are interesting dynamics to be watched out for.