Clinical trial recruitment can be a significant barrier to trial success.
Some researchers estimate upwards of 90 percent of clinical trials fail to recruit the required number of study participants causing nearly the same proportion of trials to become delayed, costing study sponsors enormous amounts of time and money.
High patient dropout and poor retention rates combined with these dreary statistics make optimizing a trial’s recruitment strategy a high priority.
Set Up Your Trial for Success
Proactive study decision-making can affect the success of a clinical trial immensely. Certain decisions, such as picking the proper sites or the number of expected participants from each site, can affect downstream efforts from the study sponsor and the sites themselves.
Additionally, successful studies have a realistic enrollment time estimate by allowing for inevitable enrollment problems in the proposed timeline.
Improper protocol design is another disastrous facet of clinical trial failure and can derail a study before it even begins. Additionally, attempting to perform a study in an area with direct competition with other studies’ recruitment efforts can contribute to study failure.
After we set up our trial for success, what strategies can we take to overcome recruitment challenges? What considerations can we make beforehand to lessen the recruitment burden? Here are a few ways to set your trial up for success before recruitment:
What Are the Top Five Ways To Optimize Trial Recruitment?
There are several methods commonly used to recruit patients. The most successful recruitment tactics involve clear communication and convenience. Let’s look at the best ways to optimize trial recruitment below.
#1: Understand the Needs of the Patient
The best way to optimize your recruitment efforts is to develop a patient-centric protocol to ensure the patient is prioritized throughout the study.
Not only will this help with initial recruitment, but patients who feel their needs are being appropriately acknowledged and addressed are more likely to remain in a study.
Developing a patient-centric protocol can be a multifaceted approach. From the beginning, creating recruitment materials directed toward the patient can grab their attention immediately.
Attractive emails or directly mailing study information can grab a potential study participant’s attention immediately.
Provide Accessible Information
Providing easy-to-read study information at a health literacy level appropriate for the target study population (usually a fourth to sixth-grade reading level) can go a long way toward promoting study comprehension.
Some successfully recruited studies employ an additional educational session, such as a brief telephone conversation, to educate the participant about the trial’s purpose.
Other commonly implemented recruitment strategies such as producing flyers, brochures, newspaper ads, and billboards can also be effective. Once again, knowing the target audience for these strategies is essential.
For example, young adults between 18 to 24 are unlikely to interact with a physical newspaper, similar to elderly adults over 70 coming across a social media advertisement.
Recruitment materials should also be geographically and culturally appropriate. If the study aims to recruit in another non-English speaking country, the materials must be translated appropriately into the local language.
Encourage Family and Community Support
Family members are often patients’ core support members. Without the moral, and sometimes literal, support from family, patients become much less likely to make appointments and adhere to prescribed medications, let alone participate in a clinical trial.
Another way to involve a different kind of family is through community outreach. Studies have shown that support from the community can be just as beneficial to patient satisfaction in a study as their biological family.
Consistent Feedback Is Key
Finally, constant feedback during the trial can tremendously improve participant retention and overall satisfaction. Consistent check-in and evaluation without being invasive can help study participants once again feel their inclusion in the study is appreciated.
#2: Utilize Referrals
A referral system is one of the best ways to improve clinical trial recruitment while saving money. Patients often prefer to hear about a trial from their healthcare provider instead of a third party.
The most effective approach to connect with prospective participants is through their primary caregivers.
When a patient’s healthcare provider offers the opportunity to participate in a study, the offer comes off less as an advertisement and more as a chance to participate in research that can benefit not only themselves but other patients with similar medical problems.
Research suggests the majority of the general public prefers to hear about a study from their primary care provider, but very few studies recruit this way. Establishing a network of providers is a low-cost, effective way to reach patients in a way they trust.
#3: Implement Technology
In today’s society, it would be a missed opportunity not to implement digital advertising to support clinical trial recruitment.
Physical media, such as flyers, brochures, and newspaper ads, have now become an expensive advertising option compared to digital advertising online. Even other audiovisual media formats such as television and radio cost more per advertisement and reach fewer potential study participants.
Social media, in particular, reaches billions of people at any given time. No other media format even comes close to how widespread and accessible social media has become.
Implementing keyword targeting and advertising on sites most likely to reach the target study audience are two great ways to utilize social media to your advantage.
#4: Provide Incentives
Incentives are a commonly used, effective tactic to recruit participants for clinical trials. Study participants often wonder what is in it for them when volunteering for a study.
Outside of furthering our clinical knowledge through responsible research, it can be challenging to incentivize participants properly. While some studies have shown that altruism is the most effective motivator to participate in research, study participants enjoy incentives that make them feel like their time in a study is appreciated.
Incentives do not have to be monetary, either. Other options include transportation to and from study appointments, hotel accommodations, and food and drink.
Ultimately, making a participant’s involvement in a study as easy as possible will benefit recruitment and retention.
#5: Don’t Forget About Patient Retention
Even with the most successful recruitment tactic, no study can succeed without adequate patient retention. Despite this, many studies fail to factor in just how vital retention can be.
While many of the previously mentioned recruitment strategies, such as family involvement and incentives at follow-up visits, can also be applied to support retention, there are additional schemes sponsors can employ.
Patient engagement can dramatically increase retention. Besides essential follow-up visits and phone calls, a more comprehensive and patient-centric approach to follow-up can be beneficial.
Knowing the patient population and the intervention or disease state being investigated can point study sponsors in the right direction.
For example, in a study of young adults 18 to 24, implementing an online chat service to discuss study concerns can effectively engage the target population. In addition to consistent participant check-in during the study, it can also be helpful to self-evaluate how the study is going.
Regular check-in and self-assessment during the recruitment phase can prove just as valuable as planning. Tracking site study participation closely can give study sponsors more insight into enrollment and retention.
Sometimes the decision has to be made to close or terminate study recruitment at a site early if the site is not on track. Doing so can limit valuable resource loss at locations that may not perform as well as others.
BONUS: Partner With a Clinical Research Organization (CRO)
Clinical Research Organizations (CRO) can be immensely helpful in orchestrating a clinical trial. CROs can considerably improve a clinical trial’s efficiency, scalability, and overall success.
While utilizing a CRO is an investment, some CROs can provide global clinical trial support and expertise in pharmaceuticals, biotechnology, and medical devices that can prove invaluable.
CROs can help navigate some of the problems and considerations previously discussed, such as regulatory concerns and protocol optimization.
At iProcess Global Research, you can expect exceptional teams and operations to provide cutting-edge research to help organizations with clinical trials.
With a constant demand for clinical trials, iProcess continues to meet the demand for specialists who can provide the high quality and competence required to facilitate clinical trial recruitment for success.
Sources:
How to Optimize Patient Recruitment | PMC
Optimizing Clinical Trials Recruitment via Deep Learning | NIH
