From a data tracker that can be attached to an inhaler to wearable tech
for those on clinical trials, a new array of gadgets are being employed
to improve medicines, improve how people use them and ultimately,
improve people’s health Clinical trials are an essential part of developing new treatments for
all types of medical conditions. According to the World Health
Organization (WHO) asthma currently affects about 235 million people
worldwide – though some estimates see this figure increase to as many as
330 million.
To improve how the condition is managed GSK has started to incorporate a
range of digital tools into its clinical trials. These digital tools,
such as adherence monitors, biosensors and electronic diaries, connect
to form a digital ecosystem, “talking” to one another in a way similar
to household smart appliances. They are designed to measure and report
the data collected in the trials as accurately as possible.
“In a clinical trial setting, you must control a lot of aspects to
make sure you collect the data correctly,” says Dave Allen, head of
respiratory research and development at GSK.
The tools integrate patients’ involvement in clinical trials for
asthma into the rest of their lives, and minimise the disruption that is
necessarily involved with multiple hospital visits.
“The more you can make the patient feel like they’re living a normal
life while they are in a trial, the more representative the results will
be,” he continues.
GSK’s inhaler works in tandem with technology company Propeller
Health’s respiratory monitoring sensor – a mountable digital device that
can be attached to an inhaler, which records usage data that is then
sent back to a user’s phone via an app, offering insights into an
individual’s asthma triggers.
In this way, a sensor can be used with rescue medication (medicine
that offers quick relief from symptoms). People with asthma will often
take a puff of their rescue medication if their asthma is not
controlled. In any clinical study for asthma, it is important to know
the amount of rescue medication people use. If people on the trial are
frequently using this medication, it may raise questions as to the
efficacy of the drug being tested.
In a similar way, the technology can be used to determine when people
have taken their regular inhaler. Says Allen: “We know that people
rarely report when they actually use their regular inhaler – they tend
to report when they should have used it. For example, we know that many
people claim to use their inhalers twice a day when in fact they don’t.”
GSK also provides a whole array of wearable tech for people taking part
in the trials. This can tell researchers whether, for example, the
people taking part have good sleep quality, how many
times they got up in the night and what sort of activity they did during
the day. This can all be digitally captured in real time, without the
need for the patient to do anything.
Different ways of assessing patient experiences include the electronic
patient reported outcomes system, ePRO, where patients enter information
about their symptoms and levels of activity on to an app. This is
cheaper and faster than speaking to a researcher face-to-face, and more
consistent and less subjective than the patient having to remember what
they felt on a previous occasion.
Digital diaries are a more open-ended way for patients to report
their experiences, as the patient writes down whatever they feel is
important to them. GSK can use data mining tools to find out patterns of
experience among thousands of patients across a study. These
experiences are recorded in real time and date-stamped.
“If you take all that data and integrate it, it becomes more valuable
than the sum of its parts,” says Allen. “So you can start to ask really
quite simple but very probing questions either across your whole study
population or at an individual patient level.”
Did they take medicine on any given day, did they use the inhaler, or
rescue medicines? And – most importantly – did they actually feel any
better? If a patient didn’t get a benefit from their drugs on a specific
occasion, was something else going on, perhaps to do with their
activity levels or other health conditions?
As this all takes place in a clinical trial setting, patient data is
encoded to the highest standards, consistent with the standards used in
clinical trials as a whole.
And then there is the bottom line: this is a much more cost-effective
way of conducting clinical trials. The expense of running trials is one
of the things that drives up research and development costs which, in
turn, is one of the elements that drives up the price of treatment.
In time, the way GSK collects and integrates this data will be an
enabler for much better medicines, finding the true value of a drug
while it is still being developed.
“At the moment, we haven’t yet realised the full potential of this
digital ecosystem; it is individual components within clinical studies,”
says Allen. “It’s operating here and now, but it’s also a work in
progress.”
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