Back in December 2013 GuideStar Clinical Trials Management and CenterWatch released the results from their survey with 183 health care professionals in US regarding challenges of conducting clinical trials in community hospitals.

Full results are available below:

Although the survey was performed with US health care professionals, the situation would be similar in other countries as well; meaning community hospitals are not very involved in clinical trials and do not benefit from them as much as they could.

What are the challenges and what could be done to improve community hospitals performance?

The survey shows that majority of the health care professionals recognize the positive impact from clinical trials but there are still limitations.

1. Clinical trials are currently breaking-even or not profitable.

Having a profitable clinical trial correlates directly with recruitment. If the hospital is not able to recruit patients, it will not be profitable and it could even be a disadvantage to take part in such trial because of the invested time and resources. 

The simple solution to such issue is to select clinical trials; which will be beneficial for the existing patient population. Sometimes the study design may look simple and straightforward but when actual recruitment commences, there are different eligibility restrictions that prevent the clinical trials team from recruiting patients. Sometimes the eligibility criteria look easy to meet and physicians are tempted to overestimate their recruitment targets. These cases could have very negative effect on the hospital performance as the clinical trials teams will not be able to deliver what they have promised and lose potential future trials due to poor recruitment.

The easiest way to overcome this challenge is to perform very good selection of the clinical trials based on patients’ population. This could be achieved by review of eligibility criteria and patients` medical records before any commitment to participate in a clinical trial.

2. Lack of resources.

Resources will always be an issue and there is no simple solution to this problem. However, there are initiatives that could raise awareness in clinical trials and get attention from hospitals staff. For example, funding from clinical trials could be used to set fund for career development trainings for hospital staff involved in clinical research. Funding participation to industry meetings will be another option hospital staff to meet colleagues working in clinical research.

Recruiting nurses and physicians who have experience in conducting clinical trials may be very beneficial.

Another option is to provide training on Good Clinical Practice and Regulatory processes. There are plenty of online trainings and also trainings provided by the regulatory agencies. Guest lectors are also a good option for providing training for staff.

3. Extra workload for the hospital staff.

It is true that the regulatory processes in clinical trials require additional attention to documentation and performed procedures but this could also be beneficial to the community hospitals. Maintaining proper and details information on patients treatment is very important for future diagnosis and treatment of the patients. Also this will increase the quality of work and hospital performance. 

Clinical trials have a strict schedule of visits and procedures that have to be performed. Often they are in addition to the standard of care. However, this will allow better monitoring of patients treatment and could increase patients’ satisfaction. 

One of the biggest advantages of conducting clinical trials is access to expensive medications, which are new on the market. Industry-funded clinical trials provide free of charge access to new frontline therapies and they could save lots of expenses to hospitals and patients. 

Author: Olga Peycheva

Olga is a clinical research professional who has been working in clinical research since 2005. She has extensive experience in clinical research in Eastern and Western Europe. 

Originally published on 2 Feb 2014