CONNECT: COvid-19 aNd TechNology- thE impact on Clinical Trial patient
Research type
Research Study
Full title
The Utilisation of Technology and its Impact on Clinical Trial Patient Care during the Coronavirus Pandemic 2020-2021.
IRAS ID
286919
Contact name
Donna Graham
Contact email
Sponsor organisation
The Christie NHS Foundation Trust
Duration of Study in the UK
0 years, 9 months, 0 days
Research summary
Research Summary
Clinical trial involvement is more resource-intense than receiving standard of care treatment and with more frequent hospital visits for patients. The coronavirus pandemic has presented many challenges in clinical trial patients’ care. To minimise the risk to patients during this period there has been a shift towards reducing on-site visits with increased use of technology e.g. virtual visits.
Currently, there is no corresponding evidence to support the use of virtual consultations in patients care whilst on clinical trials, especially in relation to the coronavirus pandemic. Our project is a single arm qualitative study at a single site. It will explore the impact that the coronavirus pandemic has had on clinical trial patients and how they feel technological advances could help or create barriers in their future care. It is hoped that, by using this information, it will be possible to address the challenges faced by patients and ensure that future application of technology in healthcare will be in a more user-centred way.
We will be disseminating questionnaires to participants currently on clinical trials within the Christie NHS Foundation Trust and following these up with virtual focus group discussions. Questionnaires will be in paper form as well as online, using the SurveyMonkey tool. The target sample size is 100 patients. Following this, focus groups will be held using the virtual meeting technology Microsoft Teams, on 3 occasions (maximum 8 patients each group) to delve further into patient experiences. Both parts of this study will comply with GDPR. The results of this study could provide increasing opportunity to implement further technology into patient care and assess any needs of patients who may be disadvantaged by the evolution of care. The Christie Charity will act as the funder for this study.
Summary of Results
Lay Summary During the COVID pandemic, hospitals brought in measures to reduce the risk of infection for patients. For many patients this meant not coming to the hospital for a clinic appointment but, instead, were contacted by the doctor by video or telephone. This can be known as a virtual consultation. This happened for patients receiving standard treatments, and also for patients on clinical trials, who may usually visit the hospital more often. Virtual consultations by video requires access to technology, and some patients were being asked to or were choosing to use technology such as smart phones, wearable devices and digital thermometers for other health reasons during this time.
The study team designed a questionnaire to understand how patients on clinical trials feel about using technology. We asked some patients to attend a focus group to get a more detailed understanding of their thoughts. Patients were given questionnaires between July 2021 and March 2022.
The questionnaire was completed by 138 patients with an average age of between 55-64 years. Most patients had internet access with smartphones being the most common piece of technology owned. Very few patients reported not using technology at all in their day-to-day life and almost one fifth said they needed help when using technology. Factors affecting patients’ confidence using technology included their education level, having access to the internet or a smartphone and having symptoms that prevent them from using technology.
Most of our participants had a virtual consultation during the pandemic. Almost one quarter who had telephone consultations felt more confident with technology and a third said they had more spare time. Almost a half of those having video consultations felt more confident with technology and one in 10 felt they had more spare time. Patients preferred having face to face consultations. A small minority would prefer virtual consultations to hospital visits. Patients wanted to have the option to attend hospital for their appointment. This was clearly seen in the focus groups also.
The pandemic did not affect how often the patients surveyed used technology. Just over a third reported using new forms of technology since the first lockdown and a similar number used other devices such as digital thermometers, pulse oximeters (devices to measure oxygen levels in the blood), blood pressure machines. Other technologies used included smartwatches and healthcare applications (eg. NHS app, NHS Test and Trace, Zoe and PatientAccess).
Almost half of the patients felt that increased use of technology in healthcare was positive, with one fifth saying it was negative. Younger participants and smartphone owners were more positive about the use of technology than older participants. Other features such as sex, education level, employment and how confident people were using technology were not linked to how people felt about technology.
The focus groups had discussions with 15 patients. Three key themes came out of these discussions. Firstly, patients didn’t feel that the technology used for healthcare was always effective and should be more personalised to their needs. Secondly, patients value the relationships they have with their teams and feel that this is very important and would prefer that they first meet hospital staff in person. Thirdly, patients felt that seeing things was important. This includes seeing scan results, diagrams to help them better understand something and seeing their doctor or nurse. They felt that using video may be better than telephone for this reason.
From this study we learned about clinical trial patients experience and expectations of technology. A small number of patients did not feel comfortable with technology before or during the COVID19 pandemic and it is important that we are aware of these patients as their confidence with technology did not improve during this time. Younger patients, and patients who owned smartphones were more positive and confident about technology use. We heard how important the quality of any technology was and that this was designed for the person using it. We also learned about the side effects that could limit a patient using technology. Just over half of patients were comfortable to have virtual appointments but seeing their team in person was more important.
We appreciate the financial support from The Christie Charity for this research. Finally, we would like to thank the participants for their contribution to this study.REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
21/EM/0081
Date of REC Opinion
20 Apr 2021
REC opinion
Further Information Favourable Opinion