Drug Research and Development for Adults Across the Older Age Span Proceedings of a Workshop (2021) / Chapter Skim
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5 Strategies for Engaging Older Adults in Clinical Research
5 Strategies for Engaging Older Adults in Clinical Research
Pages 49-64
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From page 49... ...
• Involving patient advocates in the design of a trial can im prove the trial, make it more patient-centric, and potentially save money. (Strong)
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From page 50... ...
The objective for this session was to explore approaches to better engage adults across the older age span in clinical research and clinical trials and strategies to generate evidence-based information on how to best optimize treatment for older adults. One way to incorporate a "healthy aging" approach into clinical trials is to spend time thoughtfully planning trials in a way that meets patient needs, said Collyar.
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From page 51... ...
3 and other safetynet primary care practices across the country. FQHCs are a particularly good opportunity for conducting real-world studies, said Tobin, because there are nearly 13,000 delivery sites across the United States that serve more than 25 million patients, and about one in five patients are age 55 and older.
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From page 52... ...
Being able to leverage that trust and build on those relationships, said Tobin, enhanced the ability to capture information that is routinely collected as part of care. Finally, Tobin shared details on an implementation study funded by the Administration for Community Living in two senior centers in New York City.
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From page 53... ...
Like the second study, this study brings together networks of providers, including an academic research center, a PBRN, and a network of community-based meals and educational providers. Integrating these providers enhances the ability to recruit participants, leverages trusting relationships, and increases availability of data, said Tobin.
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From page 54... ...
Blyler shared the details of the Los Angeles Barbershop Blood Pressure Study (LABBPS) , a community-based initiative that was set in barbershops to address racial disparities in hypertension (Victor et al., 2018)
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From page 55... ...
The trial identified non-Hispanic Black male barbershop patrons with uncontrolled hypertension, ages 35 to 79, and randomized them into an intervention group and a control group. Recruitment took place over the course of about 2 years; research staff spent between 4 and 6 weeks in each barbershop and offered free blood pressure screening to all patrons, regardless of eligibility for the study.
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From page 56... ...
For older adults, who are often less mobile, this may be particularly impor BOX 5-1 Personal Stories from the Los Angeles Barbershop Blood Pressure Study "I am 72 years old. I've been a customer at Long Beach Finest for over 15 years.
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From page 57... ...
Today she works as an educator and an advocate. In addition to her work at Heart Valve Voice US, she serves as an American Heart Association Heart Valve Ambassador, a PCORI Ambassador, and a research advocate, and she provides patient support through her own organization, Strong Heart Now.9 Strong shared the stories of two older men who also underwent TAVR as part of clinical research.
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From page 58... ...
The protocol was redesigned based on this feedback, which saved the sponsor money and saved potential participants from unnecessary invasive testing, Strong explained. Finding patient advocates to help with trial design can be done a number of ways, said Strong.
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From page 59... ...
A COMMUNITY PROVIDER PERSPECTIVE Steven K Rothschild, professor and chair of the Department of Family Medicine at the Rush University Medical Center, wore "three hats" for his presentation: behavioral investigator for several clinical trials, an administrator of a primary care service line, and a primary care physician still in practice.
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From page 60... ...
He characterized CHWs as "trusted, knowledgeable frontline health personnel who typically come from communities that they serve. They can bridge cultural and linguistic barriers, expand access to coverage and care, and improve health outcomes." Both CHWs and primary care clinicians have long-term relationships with the communities they serve, they have built 14 For more information, see https://www.johnahartford.org/ar2007/Model4_virtual_ integrated_practice_p5.html (accessed November 11, 2020)
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From page 61... ...
Using Electronic Health Records for Recruitment A workshop participant asked panelists for clarification about how outreach and recruitment for trials are conducted using EHRs. Tobin replied that EHRs can be used to identify eligible patients based on the inclusion and exclusion criteria.
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From page 62... ...
He noted that in a large health system, it could make sense to gather information on whether a patient would be potentially interested in clinical research to build a registry of sorts. Pracht added that before even getting to a conversation with an individual patient, it is critical to have community education to raise awareness about clinical trials.
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From page 63... ...
Pracht agreed, and reiterated her earlier call for community education about clinical trials and the need to involve caregivers in these discussions. Next Step Opportunities Collyar asked panelists to identify some concrete steps that can be taken to move forward with increasing older adult participation in research.
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