Vision for a Digital Service to Facilitate Recruitment and Retention of Older Patients in Clinical Trials

Data from randomised clinical trials shows that older patients are more likely than younger patients to experience adverse events, resulting in many deciding not to join clinical trials of experimental treatments and many patients quitting ongoing trials. The recruitment and retention problem is exacerbated by several factors, including misbelief or poor patient understanding, services not aligned with patients' needs, insufficient training of medical staff in patient communication, and the patient's feeling of being left alone. To improve patient recruitment and retention in clinical trials, we develop an innovative digital service that offers companionship to patient users using a human-centred design approach. The patient companion offers continuous availability of personalised and effective recommendations based on recognised barriers. This helps patients make more informed decisions when facing concerns about joining or staying in a clinical trial. This paper provides a research agenda to design and develop the patient companion and an illustrative example of how patient concerns could be addressed with recommendations. The results are intended to outline the feasibility of developing a patient companion and guide researchers interested in developing such an application. Importantly, it outlines the significant potential and feasibility of developing a patient companion to enhance recruitment and retention among older adults. While the research is performed in the specific context of a breast cancer treatment, the research agenda and the principles on which it is based can be generalised for any context that can benefit from a companion.