Alternative trial sites. Although large medical centers with key opinion
Since 2008, costs have
increased by 90%, to
almost $75,000 per patient in
a phase III oncology study
& over $120,000 per patient
for early phase trials.
leaders easily come to mind when choosing trial sites, there may be benefits
to exploring other options. Within the United States, community sites can
be very competitive in their ability to enroll patients. In considering any
site, it is important to evaluate productivity in past clinical trials and realtime feasibility for each new trial. When considering international sites,
it is important to select regions where the disease to be studied is prevalent.
Also important is avoiding regions already saturated with clinical trials. Latin
America, Central Eastern Europe, Asia, the Pacific Rim, and Africa are areas
to consider, although it is important to have guidance on conducting trials in
a given region before trial initiation because local laws and cultures can have
a significant impact on the success of study set-up and patient enrollment.
Communication between healthcare team members and
within study centers. Keeping trials in the forefront of the minds
of practitioners throughout a healthcare system is key to identifying
patients who might be a good fit for enrolling in various studies.
Figure 7. Strategies
to Connect Patients with Specific
Disease Profiles to Appropriate Clinical Trials
This means sharing information about ongoing and upcoming
trials among physicians, nurse practitioners, and other
healthcare team members, and between various departments.
Technology could aid in making information available to people
throughout a healthcare system. For example, an intranet site
could be used to house details of studies and their inclusion
and exclusion criteria.
Potential patients could be identified upon registration or check-in by linking ICD-9 codes to the key inclusion criteria or through the pharmacy
when oncologic compounds such as chemotherapy is ordered. An academic institution recently added a screen to the electronic medical record
that includes questions related to offering the patient a trial before access to the patient’s record is granted. Identifying multiple ways to keep
trials in front of all providers and their staff seems to work best.
clinipace.com
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