By Ruth Smith, Clinical Operations Manager, ResearchNurses.co
One of our research nurses was recently telling me about one of her home visits where a paediatric patient would happily sit while she gave her intravenous chemotherapy, as long as she was dressed as a fairy, complete with tiara and wing. The patient said that the nurse was her “get better fairy” and that the medication was “magic potion”. Working in the patient’s home allowed our nurse to provide a more personal touch resulting in a happier child and this definitely translated to happier parents. This is typical of the fundamental impact that home visits can have on the success of a clinical trial.
Home visits have been undertaken in clinical trials for many years, however historically only by a very small number of sponsors working with key vendors offering this specific service. Increasingly home visits are being recognised as a fantastic tool to improve patient recruitment, compliance and retention.
Using in-home services for patient visits can minimise the disruption of a clinical trial to a patient’s life, thus enhancing its appeal to potential participants. Home visits can provide solutions for the most common drug development challenges in clinical trials; patient recruitment; patient compliance; patient retention and patient and investigator satisfaction.
Home visits also provide an answer to the common concerns experienced by patients which may deter them from entering a study:
- Convenient – By completing the study visit within a patient’s home, it is much more convenient for the patient (and often family member, in paediatric studies).
- Flexible – Home visits can be scheduled to fit around a patient’s (and parents, in paediatric studies) daily routine, if allowed by the protocol. Visits can be performed before or after school and/or work, in a variety of locations deemed suitable and safe.
- More relaxing environment – Having a visit performed at home can minimise the anxiety of travelling into hospital. Patients generally feel safer in their own home. Patients are likely to be far more willing to enter into a clinical trial in the first place and are far more likely to stay in the study for the duration if treated and assessed at home (or school or workplace where this is appropriate).
- No travel – For some indications, particularly orphan diseases, patients may have to travel great distances for their routine care visits. To request that they travel this great distance on a more frequent basis for study purposes is likely to be off-putting, but the idea that the visit can be performed without the inconvenience and cost of travel may be much more favourable.
The value that home visits provide to assessments of patients is now being recognised and consequently the number of clinical trials incorporating home visits into the trial design is dramatically increasing.
Our ‘fairy nurse’ definitely shares the view that home visits provide an emphatic and beneficial outcome for the sufferer which, ultimately, is the gold standard! Also, the researchers conducting home visits often find the opportunity to make such an impact on the individual’s life, an extremely rewarding element of their work.