When you take a step back and look at all of the different people who play a role in a clinical trial, there are quite a few! Like any team, sport or business, each team member has a responsibility to carry out their role alongside other team members to achieve a team performance. Success or failure depends on how the individual performances come together.
Sir Alex Ferguson, widely regarded as the greatest soccer manager of all time, once said, ''The work of a team should always embrace a great player, but the great player must always work." This quote resonated with me when I began my career in clinical research. The great player in a clinical trial is the patient, and the work that the player must carry out is compliance.
Patient needs can often be unintentionally overlooked in the midst of the great operational challenges of study management, which can lead to patient compliance issues.
However, we need to remember that we are all patients at one point or another. I recently visited my physiotherapist for a painful muscle ache in my upper back. I left his office with instructions to do a routine of stretches three times a day until my next visit. At the time, his instructions seemed quite straightforward, but over the following days, some uncertainty crept in. I began to question a number of things:
• Do I fully understand how to carry out the stretches?
• If I do them incorrectly, will I do further damage?
• If I don’t do them at all, what will happen?
Three weeks have now passed and I haven’t completed the stretches as frequently or effectively as I was instructed to do. My back has improved since the initial treatment, but is still not 100%. Instead of just simply following the advice of my physio, I have been spending time googling different stretches, foam rolling techniques, etc.
My physiotherapy experience is somewhat similar to that of a patient participating in a clinical trial - although my physio’s expectations of me were far lower than what might be expected from a patient in a clinical trial. Patients often leave the investigator site without a full understanding of the instructions they have been given. The patient's only interaction with site staff on the clinical trial is often at sporadic or irregular visit windows, which can mean they simply forget some of the study requirements while going about their day-to-day life.
Promoting a sense of team between site staff and patients, promoting more regular communication, and promoting the idea that the patient is the star player whose input and feedback are critical to the success of the study and may lead to better compliance. The reality is that aside from showing up to scheduled visits, there is a lot expected of the patient in order for the trial to succeed. Everyone needs to work as a team, playing their part. Success means finding ways to get the team playing together towards the common goal.
Now - I need to get on board with my stretching homework!