Speaker
Christopher C. Butler, BA, MBChB, DCH, CCH, MD, FRCGP
Associate Head for Research
Professor of Primary Care
Professorial Fellow, Trinity College
Clinical Director, Primary Care Clinical Trials Unit
University of Oxford
Keywords
Primary Care; COVID-19; Respiratory Medicine; Adaptive Platform Trials; Large-Scale Trials; Pandemic; General Practitioners
Key Points
- Effective primary care (PC) interventions have the potential to reach a significant portion of the community and, concurrently, have a significant impact. PC is also a good vehicle for early, self-initiated interventions, which can limit illness and enhance the sustainability of health care. However, traditional clinical trials face several challenges in PC, including general practitioners’ workload crisis, opportunistic recruitment, and geographical constraints.
- The research team sought to address these challenges by conducting adaptive platform trials (APTs) that utilized sophisticated digital methods in a PC setting. PRINCIPLE and PANORAMIC evaluated multiple COVID-19 treatments simultaneously using innovative methods like remote eligibility checks, e-consent, and direct-to-participant drug delivery. The use of APTs demonstrated that large-scale, rigorous research can be successfully conducted outside of hospitals and provide real-world evidence.
- Next, the research team will conduct the ECRAID-Prime trial: An international community-based APT evaluating early treatments for acute respiratory infections to prevent hospitalizations and reduce societal illness duration. They are currently in the recruitment phase, having shifted from traditional site-based recruitment to a more decentralized approach.
Discussion Themes
The National Health Service (NHS) and publicly funded clinical trials units are mission-critical because they prioritize health outcomes over profit and provide a “warm base” for rapid research.
Dr. Butler noted that busy general practitioners participated because they bought into the values and the importance of the research questions, especially when administrative burdens were minimized.