The Rethinking Clinical Trials (REaCT) Program. A Canadian-Led Pragmatic Trials Program: Strategies for Integrating Knowledge Users into Trial Design.

Deanna Saunders,Brian Hutton,Mark Clemons,Lisa Vandermeer,Mashari Jemaan Alzahrani,Michelle Liu

doi:10.3390/curroncol28050337

Deanna Saunders, Brian Hutton + Show 4 more

Open Access

https://doi.org/10.3390/curroncol28050337

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Abstract

We reviewed patient and health care provider (HCP) surveys performed through the REaCT program. The REaCT team has performed 15 patient surveys (2298 respondents) and 13 HCP surveys (1033 respondents) that have addressed a broad range of topics in breast cancer management. Over time, the proportion of surveys distributed by paper/regular mail has fallen, with electronic distribution now the norm. For the patient surveys, the median duration of the surveys was 3 months (IQR 2.5–7 months) and the median response rate was 84% (IQR 80–91.7%). For the HCP surveys, the median survey duration was 3 months (IQR 1.75–4 months), and the median response rate, where available, was 28% (IQR 21.2–49%). The survey data have so far led to: 10 systematic reviews, 6 peer-reviewed grant applications and 19 clinical trials. Knowledge users should be an essential component of clinical research. The REaCT program has integrated surveys as a standard step of their trials process. The COVID-19 pandemic and reduced face-to-face interactions with patients in the clinic as well as the continued importance of social media highlight the need for alternative means of distributing and responding to surveys.

Highlights

There are many barriers to performing clinical trials and in recent years the number of adult cancer patients accrued to trials has steadily fallen [1]
We present our own experience with performing surveys, including lessons learned, as well as our thoughts on how performing surveys will need to evolve with the likely irreversible reduction in in-person patient visits that has occurred as a consequence of the COVID-19 pandemic [21]
Patient Survey Outcomes Outcome data collected from patient surveys included patient demographics, how potential survey participants were identified, how participants were contacted for survey participation, how surveys were distributed to participants, and how survey responses were collected

Summary

Introduction

There are many barriers to performing clinical trials and in recent years the number of adult cancer patients accrued to trials has steadily fallen [1]. The REaCT investigators have performed 20 randomized trials at 16 centres and has accrued over 3300 patients. The mandate of these trials has been broad, and has covered many aspects of the “cancer journey” (Figure 2) including surgery [7], pathology [8], radiology [9], device use [10,11], antiemetic support [12,13], adjuvant treatment [14], adjuvant supportive care [15] and palliative/supportive care [16]. REaCT has performed feasibility studies to assess whether expansion to larger definitive studies would be possible [4,14,17,18]

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Conclusion