National Heart Lung Institute, Imperial College London, London, United Kingdom; Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield Trust, London, United Kingdom.
School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom.
J Cyst Fibros. 2021 Nov;20(6):986-993. doi: 10.1016/j.jcf.2021.03.021. Epub 2021 Apr 21.
Making trials more patient-centred improves recruitment and retention, patient satisfaction and makes research accessible to a more representative population. We aimed to understand the factors that influence participation and engagement in clinical trials in cystic fibrosis (CF) trials to guide the rational design and delivery of patient-centred trials.
We used a Delphi process, supported by extensive literature review and 3 workshops, to determine which factors stakeholders think exert significant influence in participation and engagement in CF trials. Panellists were recruited from across the UK and the study was administered online.
We had representation from 19 CF centres; 28 people with CF (pwCF), 26 parents and 30 healthcare professionals (HCPs). Panels were presented with a shortlist of 104 factors and asked which they thought influence participation and engagement in CF trials. After 3 iterations, 43 statements met consensus for pwCF, 48 for the parents and 69 for the HCPs.
We identified many targets to make trials more patient-centred. Whilst some require an overhaul of trial delivery, many are relatively easy to implement. We outline a list of 'dos and don'ts' for sponsors and research teams including: focus on good communication; recognise that lack of time is the greatest barrier to trial participation so minimise the frequency and length of visits; help participants fit trials around busy lives; remember trial participation can be a major life-event and support participants accordingly; and don't underestimate the impact of simple strategies e.g. on-site access to Wifi and cups of tea.
使试验更加以患者为中心可以提高招募和保留率、患者满意度,并使更多具有代表性的人群能够参与研究。我们旨在了解影响囊性纤维化(CF)试验参与和参与的因素,以指导以患者为中心的试验的合理设计和实施。
我们使用 Delphi 流程,通过广泛的文献回顾和 3 次研讨会,确定利益相关者认为对 CF 试验的参与和参与有重大影响的因素。参与者是从英国各地招募的,研究是在线进行的。
我们有 19 个 CF 中心的代表;28 名 CF 患者(pwCF)、26 名家长和 30 名医疗保健专业人员(HCP)。小组收到了一份包含 104 个因素的简短名单,并被要求选择他们认为会影响 CF 试验参与和参与的因素。经过 3 轮迭代,43 项陈述得到了 pwCF 的一致认可,48 项陈述得到了家长的一致认可,69 项陈述得到了 HCP 的一致认可。
我们确定了许多使试验更加以患者为中心的目标。虽然有些目标需要全面改革试验的实施方式,但许多目标都相对容易实现。我们为赞助商和研究团队列出了一份“应该做和不应该做”的清单,包括:专注于良好的沟通;认识到缺乏时间是参与试验的最大障碍,因此尽量减少访问的频率和长度;帮助参与者在忙碌的生活中安排试验;记住试验参与可能是一个重大的生活事件,并相应地支持参与者;不要低估简单策略的影响,例如现场提供无线网络和茶水。