By Deborah Borfitz
April 7, 2008 | Harlow, Essex (UK)-based Exco InTouch recently released the latest version of its contact management software, known as REACT, which uses cell phone text messaging to do everything from pre-screening potential clinical trial participants to sending treatment and appointment reminders to enrolled subjects.
Version 3.0 of REACT “provides a means by which an organization can connect directly to specific clinical audiences with tailored, high-impact communications,” says Tim Davis, co-founder of Exco InTouch. REACT uses global mobile messaging capabilities, a customized website through which text messages get channeled, and investigator site staff to create a “seamless participant experience.”
All text messages are sent in patients’ local language according to local time zones, says Davis. Message content is typically pre-configured, although “for some studies the site personnel can personalize messages to patients.” Patients can reply to text messages directly to confirm or reschedule appointments, and the data gets relayed via REACT to the clinical site. Sites can also receive reminders about when to expect patients and when trial milestones have been met or missed.
Medication and visit reminders “significantly” improve patient compliance with the study protocol and “dramatically reduces…‘lost to follow up’ rates,” says Davis. Patients can be reminded to continue taking medication even if they feel better or are experiencing “normal” side effects. Motivational and educational messages can also be included, as can site phone numbers to aid contact with the investigator or study nurse.
For purposes of patient recruitment, REACT can be used “by clinical sites, Phase I units, SMOs [site management organizations], CROs [clinical research organizations], and patient recruitment specialists to blast text messages out to known patients/volunteers/participants to let them know that there is an upcoming trial that they may be interested in,” says Davis. Typically, 75 percent of responses are gathered “within the first three hours of the message being sent, and the rest within the next six-hour period.” REACT also can be used in conjunction with an advertising campaign where there will be a “call to action” that includes the text messaging option.
In both scenarios, Davis adds, this could enable pre-screening questions to be sent establishing eligibility and geographic location for follow-up contact. “Collecting data like zip codes can help funnel the right patient to the right site in a timely manner by prompting the patient to call a local site number or, more commonly, for a site/call center to call the patient directly.”
REACT has truly “global reach” because cell phones are so ubiquitous. “We can provide cell phones to patients who do not own one,” says Davis. “But with over 45,000 patients we have worked with to date, we have only sent 39 cell phones, and this is across 41 countries.” Worldwide, there are over 3.3 billion active cell phones – versus only 1.2 billion active email inboxes.
Customers not looking for a stand-alone application can have REACT integrated with clinical trial management or safety systems (electronic or paper-based) as well as electronic data capture, through a secure encryption of mobile user data, Davis says. For most trials, a secure database simply stores the cell phone numbers and personalized message schedule for individual patients. Medication schedules or dose frequencies might also be stored.
To date, REACT has been used for 19 trials and has enjoyed a high acceptance rate among clinical sites, says Davis. Fees range from about $1 per patient per month for a five-year project with 6,000 patients to $10 per patient per month for a two-year study with 600 patients.
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