R’Kes Starling leverages technology to expand access to clinical trials for underrepresented populations
It all started with his mother. That’s how R’Kes Starling (BS ’02) attributes his inspiration for founding Reveles, an AI-powered patient engagement company that partners with drug sponsors and research institutions to increase awareness and expand clinical trial access to underrepresented patients. By prioritizing diversity within studies, Reveles helps to ensure marginalized communities do not miss out on life-changing care while simultaneously advancing a more equitable approach to health care.
Several years ago, Starling’s mother was diagnosed with a rare lung disorder. She’s since learned to manage her condition, but at the time, Starling was worried about her health and focused on getting her the best possible care. He was then working for McKesson as vice president of specialty pharmacy and clinical research services. Familiar with the essential role clinical trials play in advancing the knowledge of medicine, as well as the hope they provide to participants, Starling suggested they search for a clinical trial for his mother.
“We eventually found a trial, but the research site was 1,600 miles away,” Starling says. “When my mother expressed her disappointment that there was a clinical trial available, but she didn’t have access to it, that was a pivotal moment for me.”
With Reveles, named for the Latin word meaning “to discover,” Starling wants to not only eliminate barriers to access clinical trials, but also diversify participation in those trials. In 2020, the Food and Drug Administration reported that participation in clinical trials was 75% white, 56% women and 30% age 65 and older. Furthermore, 50% of FDA trials in the U.S. are conducted in only 1% to 2% of zip codes. Because age, genetics, gender, weight, racial heritage and geographic location can all impact the efficacy and safety of treatment on an individual, targeting subgroups to address these factors is critical.
“None of the medical providers treating my mother even mentioned the option of clinical trials,” Starling says. “Here I was, a trained pharmacist, running a large-scale research services operation and I had difficulty finding a clinical trial for my mother. What about other patients and families who are less familiar with the complexities of the health care system? I realized that one of the reasons people of color aren’t participating in clinical trials and contributing to advancements in medicine and scientific innovation is because we aren’t being asked.”
Traditionally, most clinical trials are conducted on-site at an academic medical center, clinical research center or university campus. However, many standard clinical procedures — such as biospecimen collection or taking vitals — can be safely, effectively and efficiently completed in the comfort of a patient’s home. By eliminating the geographical restrictions and reducing the burden of participation, Reveles makes clinical trials more accessible for historically marginalized communities.
Starling and his team work with drug developers to devise patient-centered clinical studies that leverage technology to educate potential participants about the trial, obtain consent, collect data, monitor telehealth devices and facilitate communication via telemedicine. Through integrated home health care solutions, they can even manage delivery of collected biological specimens. But first, they must establish relationships within the patient community.
“Engagement and education are fundamentally the cornerstone of everything we do,” Starling says. “You cannot begin a discussion about clinical trials until you have fostered genuine connection within a community. That conversation starts with creating trust to empower people to make an informed decision about giving themselves to science. These companies are going to make millions of dollars off patient data, so it’s important to recognize that patients are partners in this journey.
“We need to shift the discussion from enrolling and recruiting participants for clinical trials and instead connect with patients to build interest and awareness through education. That’s the heart of Reveles.”
This story appeared in the 2024 issue of The Purdue Pharmacist magazine.
