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Grenier C, Loniewski M, Plazy M, Onaisi R, Doucet MH, Joseph JP, Duvignaud A, Malvy D, Anglaret X, Orne-Gliemann J. Implementing an outpatient clinical trial on COVID-19 treatment in an emergency epidemic context: a mixed methods study among operational and research stakeholders within the Coverage trial, Bordeaux (France). Arch Public Health 2022; 80:245. [PMID: 36463300 PMCID: PMC9719237 DOI: 10.1186/s13690-022-00999-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 11/09/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The emergency set-up and implementation of outpatient clinical trials on epidemic emerging infectious diseases such as COVID-19 raise many issues in terms of research structuration, regulations, and health systems organization. We aimed to describe the experience and points of view of different stakeholders involved in a French home-based outpatient trial on COVID-19 and to identify the early barriers and facilitators to the trial implementation. METHODS We conducted a mixed-methods study in July 2020. A self-administered questionnaire was emailed to 213 clinical, operational and research stakeholders involved in the Coverage trial; individual semi-directed interviews were conducted among 14 stakeholders. Questionnaire data and written interview notes are presented together by key theme. RESULTS One hundred fifty six stakeholders responded to the questionnaire. 53.4% did not have prior experience in clinical research. The motivation of most stakeholders to participate in the Coverage trial was to feel useful during the pandemic. 87.9% agreed that the trial had an unusual set-up timeframe, and many regretted a certain lack of regulatory flexibility. Mobile medical teams and specific professional skills were perceived as instrumental for outpatient research. CONCLUSIONS The implementation of a home-based outpatient clinical trial on COVID-19 was perceived as relevant and innovative although requiring important adaptations of usual professional responsibilities and standard research procedures. Lessons learned from the Coverage trial underline the need for improved networks between hospital and community medicine, and call for a dedicated and reactive outpatient research platform on emerging or threatening infectious diseases.
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Affiliation(s)
- Carine Grenier
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, Bordeaux, France ,grid.508062.90000 0004 8511 8605National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux Population Health Research Centre, Bordeaux, France ,Research Institute for Sustainable Development (IRD) EMR 271, GHiGS, Bordeaux, France
| | - Macha Loniewski
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, Bordeaux, France ,grid.508062.90000 0004 8511 8605National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux Population Health Research Centre, Bordeaux, France ,Research Institute for Sustainable Development (IRD) EMR 271, GHiGS, Bordeaux, France
| | - Mélanie Plazy
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, Bordeaux, France ,grid.508062.90000 0004 8511 8605National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux Population Health Research Centre, Bordeaux, France ,Research Institute for Sustainable Development (IRD) EMR 271, GHiGS, Bordeaux, France
| | - Racha Onaisi
- grid.412041.20000 0001 2106 639XDepartment of General Practice, University of Bordeaux, Bordeaux, France
| | - Marie-Hélène Doucet
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, Bordeaux, France ,grid.508062.90000 0004 8511 8605National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux Population Health Research Centre, Bordeaux, France ,Research Institute for Sustainable Development (IRD) EMR 271, GHiGS, Bordeaux, France
| | - Jean-Philippe Joseph
- grid.412041.20000 0001 2106 639XDepartment of General Practice, University of Bordeaux, Bordeaux, France
| | - Alexandre Duvignaud
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, Bordeaux, France ,grid.508062.90000 0004 8511 8605National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux Population Health Research Centre, Bordeaux, France ,Research Institute for Sustainable Development (IRD) EMR 271, GHiGS, Bordeaux, France ,grid.42399.350000 0004 0593 7118Department of Infectious Diseases and Tropical Medicine, Division of Tropical Medicine and Clinical International Health, CHU Bordeaux, Bordeaux, France
| | - Denis Malvy
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, Bordeaux, France ,grid.508062.90000 0004 8511 8605National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux Population Health Research Centre, Bordeaux, France ,Research Institute for Sustainable Development (IRD) EMR 271, GHiGS, Bordeaux, France ,grid.42399.350000 0004 0593 7118Department of Infectious Diseases and Tropical Medicine, Division of Tropical Medicine and Clinical International Health, CHU Bordeaux, Bordeaux, France
| | - Xavier Anglaret
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, Bordeaux, France ,grid.508062.90000 0004 8511 8605National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux Population Health Research Centre, Bordeaux, France ,Research Institute for Sustainable Development (IRD) EMR 271, GHiGS, Bordeaux, France
| | - Joanna Orne-Gliemann
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, Bordeaux, France ,grid.508062.90000 0004 8511 8605National Institute for Health and Medical Research (INSERM) UMR 1219, Bordeaux Population Health Research Centre, Bordeaux, France ,Research Institute for Sustainable Development (IRD) EMR 271, GHiGS, Bordeaux, France
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