Harnessing a digitally savvy older generation for clinical trials
Australians enjoy one of the highest life expectancies in the world, currently sitting at 82.8 years for men and women combined. We’ve seen a continued upward trend since the 1890s when life expectancy sat at around 53 years.1
The demographic shift accompanying this trend means that ensuring that good health is extended into old age has never been more important. A sizeable older population that is healthy increases economic productivity, reduces health costs, and gives grandchildren the great fortune to enjoy quality time with their older relatives.
The STAtins in Reducing Events in the Elderly (STAREE) study tackles one aspect of this health challenge, by investigating whether cholesterol-busting statin drugs can prolong good health among already healthy 70+ year olds. It’s well recognized that their protective effects benefit those who have experienced a cardiac event (heart attack) or stroke, but it’s not known whether the benefits of preventive daily statins outweigh the risks to those that are healthy.
The pandemic has thrown numerous challenges in the way of the study’s coordinators, but they’ve met those challenges by using technology to pivot to an online delivery mode where possible. During 2021, the team still randomized 1,004 new participants, undertook 6,356 study appointments with participants, and on-boarded 277 new GP co-investigators.
But it’s not just the study team that have had to adapt and embrace technology.
Senior Clinical Trials Manager Dr Simone Spark has been impressed by the flexibility and willingness of their older set of participants to engage with the technologies that have allowed the study to thrive throughout COVID-19. She believes this is something that can harnessed by medical researchers, and provides yet more evidence of the need to support our older population in continuing to live rich and engaged lives that are filled with purpose and social interaction.
She says, “When we were planning this study a few years ago, a common discussion that would come up was around how we would engage and communicate with our participants. There was an assumption that face-to-face appointments and study updates would be preferred, and that printed newsletters would be better received than e-newsletters.
“It wasn’t long before we realized these assumptions weren’t really holding water, and that this generation of 70+ year olds is far more comfortable with online surveys and using mobile phones than previous. In 2019, we presented data from our study records at the Australian Clinical Trials Alliance conference.”
Study data revealed that of the 5,800 participants aged 70-96 years old, 87.4 per cent had provided an email address, mobile phone number, or both upon joining the study. When SMS was used to deliver study-related tasks to participants, 71 per cent of these tasks were completed within 10 days. Three online surveys presented to participants had an 84 per cent completion rate, with an average turn around time of 1.2 days. When the team calculated the cost-savings associated with the online survey against the paper-based survey, they found an average saving of $50 per participant, adding up to around $290,000 across all 5,800 participants.
Dr Spark says, “Community-based trials involving older people need to be engaging with them via digital platforms. They’re engaged, they’re willing. It can save money for the trial, it saves paper going to waste, and it saves the participants time.
“It also reinforces that physical health isn’t the only aspect of healthy ageing we need to take seriously. Our digitally savvy older population is engaged and connected with the world via technology. We need to understand how that can be nurtured and extended, and be wary of how that connectivity might be abused.”
During the pandemic, the study’s regular community updates have also moved online. Previously hosted as large in-person Town Hall style gatherings, two webinars were provided throughout 2021, with 500 participants dialing into the first, and 450 to the second.
“The pandemic has driven so many aspects of life online, and there’s even greater acceptance than before. I’m looking forward to updating our 2019 data, and seeing what effect can be seen among our participants now.”
References
- AIHW data from https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/life-expectancy accessed 16th March 2022