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The Site Perspective: Clinical Research is Rewarding and Important, But They Feel Ignored

As the industry moves toward setting up de novo sites and bringing in more community centers, what is operationally realistic for them needs to be understood. What works for sites and what alienates them?

Too often, however, only key opinion leaders at large academic institutions contribute their perspectives to sponsors and provider organizations. That creates a blind spot in seeing what smaller sites need.

The 2023 Avoca State of the Industry Survey solicited insights from all stakeholders, including sites. The resulting report summarizes key findings to provide a 360-degree view on what motivates and deters clinical trial participation. These findings can inform decisions about encouraging site and patient participation in clinical trials.

Committed to the Science and the Patient

Investigators and site teams participate in trials for all the best reasons. They want to do good in the world. Almost all site staff that were surveyed indicated a desire to contribute to the advancement of science (96%) and the ability to bring new or better treatments to patients (95%).

They also want to learn the latest science: 89% cited interest in the new treatment being researched, and 87% indicated a desire to stay up-to-date on treatments in their specialty area.

They want to be part of clinical research. They truly believe in the good that clinical trials can do. They are committed to the science and to the participants.

The survey revealed something else: They are frustrated and often struggle with the way trials are executed.

Overlooked and Overburdened

As one site respondent put it, “The benefits for people and the improvements in medicine, far outweigh the stress, incompetence, issues, faulty devices, or changes that occur during a clinical trial. They are all different, but they all have issues in one way or another.”

Perhaps the biggest issue is that sites feel overlooked and overburdened. In fact, only 15% of site respondents strongly agreed that clinical trials are designed with sites/site staff in mind.

This manifests itself in several ways. Only 31% strongly agreed that budget negotiation and contracting was timely and efficient for them, and only 38% strongly agreed that the protocol was clear and easy to follow.

They are, nevertheless, following the protocols: 80% said they strictly followed the protocol in their most recent trial, and 13% said they mostly followed it. It’s worth noting here that sponsors and providers took a quite different view: Only 21% said sites strictly follow the protocol with no or little deviation.

It’s less of a matter of who’s right and who’s wrong than it is an illustration of the profound gap in understanding.

It’s time to listen to the sites — all the sites.

Building Trust

Clear and timely communication with site staff and investigators will go a long way toward closing this gap. This includes providing training and resources, engaging with them regularly, and answering their questions and concerns promptly.

It also involves soliciting their opinions before finalizing a protocol. Sponsor and provider organizations must capture diverse site voices to align with their needs and capabilities.

As the survey reveals, sponsors and provider organizations must broaden horizons and attend to the needs of research-naïve participants and investigators. By doing so, they can reduce barriers to participation for sites and patients, improve the quality of data, and achieve a smooth and successful trial.

Download the full 2023 Avoca State of the Industry Report for more insights from sponsors providers, sites, and patients.

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