Remotely Delivered Clinical Trials in Older Adults: The Future of Inclusive Research?

Background Older people are still not included in many clinical trials resulting in a poor evidence base for older people’s medicine. Remote trial delivery represents a way to improve this. Despite recent advances in technology, there is a lack of research regarding participants’ perspectives on remote research delivery. This study aimed to compare remote physical performance and anthropometric measurements to those taken in-person, and to present participant perspectives on remote trials, utilising findings from the remotely delivered PROMOTe trial. Methods All trial participants (n=72) were invited to complete questionnaire. A subset was invited to attend an in-person visit within 48hours of final video-visit. Bland-Altman plots (95% limits of agreement [LOA]) were employed to compare weight, height, grip strength, and chair-stand time. Results Fifty-eight (81%) participants completed the questionnaire (age mean 73.3 years, SD 5.0). Over half (31/58, 54%) had no preference between remote or in-person participation. Of those who preferred remote participation, a majority (5/7, 71.4%) stated this was to avoid travel. Of those who preferred in-person, a majority stated they liked to talk to staff face-to-face. Sixteen individuals attended in-person validation visits (age mean 75 years, SD 1.7). All (32/32, 100%) measurements of chair stand time, weight, gait-speed and overall short physical performance battery score and 94% (30/32) of measurements of height and grip strength fell within LOA, and there were no statistically significant within person differences between remote and in–person measurements. Conclusion Most participants found remote trial delivery both acceptable and manageable. Remotely measured physical performance was highly comparable to in person, supporting use of remote physical measurements in older adults. It should not be assumed that older people will not be able to manage technology or other aspects of remote trial delivery. Researchers should aim for flexible, responsive study designs ensuring the inclusion of older people.