Patient Input to Protocol Design

The purpose of the Patient Input to Protocol Design stop is to include patient input and insights into protocol design. 

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Description

Patient input to protocol design is the process of soliciting and incorporating the perspectives and experiences of patients into the design of clinical trials. This can be done through a variety of methods, including patient advisory boards, focus groups, and surveys. Regulators increasingly expect patient and or caregiver input to protocol design and execution plans.

Benefits:

  1. Helps to ensure that the trial is designed in a way that is feasible and convenient for patient participation
  2. Proactively identify potential barriers to participation and develop strategies to overcome them.
  3. Helps to ensure that the trial is measuring outcomes that are important to patients.

DCT-specific Considerations/Inputs

Convenience: Patients should be able to participate in the trial in a way that is convenient for them. That includes increased optionality for trial participation - offering ways to participate that are not limited to a traditional research site. This may mean using remote monitoring technologies (e.g. data collection using wearables), conducting visits in the patient's home, or providing flexible scheduling options, and leveraging technology platforms for data collection directly from patients (eCOAs)

Accessibility: Patients should be able to access the trial regardless of their location, income, or insurance status. This may mean providing financial assistance, transportation reimbursement, or other support to enable their participation.

Support: Patients should have access to support throughout the trial process. This may include providing educational materials, a dedicated patient contact, and /or a technical support group.

Privacy: Patients must have their privacy protected throughout the trial process as dictated by regulations and local laws

Trust: Patients need to establish trust with the research staff and the trial process. Providing transparent information about trial participation expectations and duration, potential risks and benefits, and any financial or other support can help build trust.


Tools

Patient Journey Maps

Best Practices Rubric


Regulatory Documents

FDA/U.S.

U.S. FDA Final Guidance Document: Digital Health Technologies for Remote Data Acquisition in Clinical Investigations

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U.S. FDA Final Guidance Document: Conducting Clinical Trials With Decentralized Elements Guidance for Industry, Investigators, and Other Interested Parties - September 2024

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FDA Patient-Focused Drug Development: Collecting Comprehensive and Representative Input, June 2018

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Europe/EMA

European Medicines Agency Recommendation Paper on Decentralised Element in Clinical Trials Version 01, 13 December 2022

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ICH Guideline E8(R1) on General Considerations for Clinical Studies, Dec 2022, Section 2.3

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Reference Documents

Transcelerate Planning for Patient Engagement Toolkit

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CTTi Patient Engagement Toolkit

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Patient Focused Medicines Development: Patient Engagement Tools and Open Access workstreams

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MRCT IRB/EC Considerations - Full Document

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MRCT IRB/EC Considerations - Devices

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MRCT IRB/EC Considerations - Connected Sensors

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MRCT IRB/EC Considerations - Remote Visits

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CTTI Recommendations: Planning for Successful Trial Recruitment

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CTTI Recommendations: Decentralized Clinical Trials

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DECISION TREE: OPTIMIZING YOUR PROTOCOL DESIGN

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HOW TO IDENTIFY & PRIORITIZE TRIAL STAKEHOLDERS

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CTTI Considerations for Advancing the Use of Digital Technologies for Data Capture & Improved Clinical Trials

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Paladin Consortium Playbook - Collaboration throughout the Research and Drug Development Process

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NIH - Informed Consent for Research Using Digital Health Technologies

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