Celebrating Clinical Trials Day: A Conversation with Melanie Carr, a Clinical Trials Manager at the Primary Care Clinical Trials Unit (CTU)

 Trial management thrives on diversity. We need people from all walks of life to ensure research is truly inclusive and representative.

Clinical trials are the foundation of new treatments and medical breakthroughs. They help us discover better ways to prevent, diagnose, and treat diseases. This work is impossible without the team work of dedicated professional and participants. Often, we hear about the outcomes of clinical trials, but what does it take to make them possible? We spoke to one of them: a trial manager. 

Tell us about yourself and your role.

I’m Melanie Carr, a Trial Manager in the Primary Care CTU. I work on the Optimising treatment for mild hypertension in older people at risk of adverse events trial which is commonly known as OPTIMISE 2 trial. It investigates whether safely stopping blood pressure medications (deprescribing) in older people with mild hypertension is safe and effective over a longer period of one year or more. This trial follows from the OPTMISE study and is larger and will investigate participants on a longer term basis. 

My work revolves around orchestrating the many moving parts that make clinical trials possible, ensuring that every detail-no matter how small-supports the bigger mission of advancing health research.

Clinical Trials Day commemorates James Lind’s first controlled trial in 1747. In your experience, what’s been the most significant change in clinical trials?

The biggest shift I’ve seen is in public perception. Ten years ago, mentioning clinical trials often drew skepticism. Now, thanks to recent public health crises like bird flu, Ebola, and especially COVID-19, there’s a growing curiosity and respect for research. People are more likely to see clinical trials as essential, not mysterious-a change that’s helping to break down barriers and stigma.

What makes managing clinical trials uniquely challenging?

No two trials are the same, and that’s what keeps things interesting. During the COVID-19 pandemic, for example, delivering medications safely and quickly to participants was a logistical puzzle. In my current trial, OPTIMISE2, the challenge lies in coordinating over 180 GP practices-making sure every site has what they need to support participants. It’s a massive team effort, with every detail crucial to success.

How do you ensure diverse recruitment in your trials?

Inclusivity is a personal priority. For OPTIMISE2, I advocated for a more comprehensive demographic section in our trial database so we can track and improve inclusivity as we go. It’s also about scrutinising inclusion and exclusion criteria to avoid unintentionally leaving anyone out. Collaborating with colleagues, we’ve audited our CTU’s trials using NIHR INCLUDE guidance and formed a working group to keep pushing for better representation of under-served groups.

The NIHR INCLUDE guidance defines under-served groups in health research, provides a roadmap for improving their inclusion, identifies specific groups and barriers, offers a framework of guiding questions for research teams and funders, and shares examples of good practice and resources to enhance inclusion in health and care research.

What do you wish more people understood about trial managers?

Trial managers are the engine room of research. We work behind the scenes, connecting the vision of investigators, the dedication of healthcare teams, and the commitment of participants. Our work often goes unnoticed-until something urgent needs fixing! But we’re the powerhouse that keeps trials moving and results coming.

What’s one pandemic-era innovation that should become standard?

It might sound mundane, but electronic document signing has been a game changer. Pre-pandemic, getting signatures meant chasing people down or sending paperwork by post, causing frustrating delays. Secure electronic signing has sped up processes, saved money, and reduced our environmental footprint-a win all around.

What message would you share with someone considering a career in trial management, especially in community-based or inclusive research?

If I can do it, you can. My background is in history, not science, so I bring a fresh perspective-if I don’t understand the language in our documents, chances are participants won’t either. Trial management thrives on diversity. We need people from all walks of life to ensure research is truly inclusive and representative. The work is rewarding, and the impact is real: seeing participants in OPTIMISE2 contribute to research, often for the first time, reminds me why this work matters.

Read more on Melanie's work here.

This Clinical Trials Day, let’s celebrate the teamwork, innovation, and dedication that make every breakthrough possible. Whether you’re a participant, a researcher, or just curious-your engagement helps shape the future of health for all.

How you can get involved

• Interested in participating in a clinical trial? Visit Be Part of Research to learn more.
• Access tips for promoting clinical trials on social media.
• Read the comprehensive Health Research Authority (HRA) guidance on how to conduct inclusive and diverse clinical trials. 

The Centre for Research Equity celebrates the dedication of professionals like Melanie who work tirelessly to ensure that clinical research benefits and represents all communities.