Key considerations for digital decentralised clinical trials from a feasibility study assessing pacing interventions for long COVID

Sci Rep. 2024 Sep 27;14(1):22083. doi: 10.1038/s41598-024-61827-4.

Abstract

Post COVID-19 condition or long COVID is highly prevalent and often debilitating, with key symptoms including fatigue, breathlessness, and brain fog. There is currently a lack of evidence-based treatments for this highly complex syndrome. There is a need for clinical trial platforms to rapidly evaluate nonpharmacological treatments to support affected individuals with symptom management. We co-produced a mixed methods feasibility study to evaluate a multi-arm digital decentralised clinical trial (DCT) platform to assess non-pharmacological interventions for Long COVID, using pacing interventions as an exemplar. The study demonstrated that the platform was able to successfully e-consent participants, randomise them into one of four intervention arms, capture baseline data, and capture outcomes relevant to a health economic evaluation. The study also highlighted several challenges, including difficulties with recruitment, imposter participants, and high attrition rates. We highlight how these challenges can potentially be mitigated to make a fully powered DCT more feasible.

Keywords: Decentralised trials; Feasibility study; Long COVID; PROMs; Pacing intervention.

MeSH terms

  • Adult
  • Aged
  • COVID-19* / epidemiology
  • COVID-19* / therapy
  • Clinical Trials as Topic
  • Feasibility Studies*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Post-Acute COVID-19 Syndrome
  • SARS-CoV-2

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