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Patients in clinical trials as subjects
Patient participation can include a broad spectrum of activities for human subjects during clinical trials and has become associated with several other words such as “patient engagement” or “decision making.”

In the US, trends in patient participation have been influenced by a variety of sources and previous political movements. One such source for patient participation in clinical research was the AIDS epidemic in the 1980s and 1990s. During the epidemic, the AIDS activists argued not only for new clinical trial models, but for the importance of additional social service groups to support a wider range of potential human subjects. Since then, the FDA has taken several steps to include patients earlier in the drug development process. The authorization of Prescription Drug User Fee Act (PDUFA) V in 2012 included the Patient-Focused Drug Development (PFDD) initiative to provide the FDA with a way of hearing the patients’ perspectives and concerns. Similarly, the European Medicine Agency (EMA) has been attempting to incorporate patient perspectives during the evaluation of medicinal products by the EMA scientific committees.

There has been an increased interest among healthcare providers, such as nurses, in cultivating patient participation. Due to this increased interest, studies have been done to assess the benefits and risks of patient participation and engagement in research. For benefits, patient engagement improves patient outcomes as well as clinical trial enrollment and retention. For risks, it has been proposed that the inclusion of patient participation may lead to extended research times and increased funding for clinical trials.

A few of the tools used to cultivate patient participation in clinical research have been the growth of patient organizations along with the development of databases and patient registries. These tools allow for the mass collection and dissemination of data. Registries, specifically, do not only allow patients to access personal information, but registries also allow physicians to review the outcomes and experiences of several patients who received treatment with medicinal products. Furthermore, registries and patient participation have been particularly important to the development of rare-disease medicines. In the US, the Rare Diseases Clinical Research Network (RDCRN) was created in 2003 which includes a registry for patients afflicted with a rare-disease. This registry provides information to the patients and allows physicians to contact potential patients for enrollment in clinical trials.