Site-Based Clinical Trial Recruitment: How Can We Address Challenges?

Nandini Nayar, Senior Vice President for Commercial Operations, Antidote

Nandini Nayar, Senior Vice President for Commercial Operations, Antidote

This article is the second in a series on patient centricity in clinical trials (first in series).

It’s no secret that recruiting patients for clinical trials can be difficult. Average people aren’t well-informed about what it means to be in a clinical trial, nor how to find one for which they may qualify. Patients tend to want to discuss trials with their doctors, but with the average doctor’s appointment lasting just 13-16 minutes, there often isn’t time. It can also be difficult for doctors to keep up with the details of so many new trials starting every day.

In the digital age, patients search for research studies online, but with many of the registry sites, results can be overwhelming and hard to understand. Site-based clinical trial recruitment can work, but how can sites cut through the noise and recruit eligible and engaged patients for their studies? How can we shift from trial-centric to patient-centric recruiting?

Traditional Outreach for Recruitment

For a long time, site-based recruitment was largely trial-centric, traditional advertising. Sites would consider their protocol, pull out the most important eligibility piece or two, and create newspaper ads, radio spots, billboards, and print materials to be distributed at doctors’ offices. Even if a patient didn’t end up eligible for a particular trial, sites would add their name to a database, saving them for outreach down the line. Once that database grew, sites would tap into those patient lists for new trials.

Even today, these traditional methods are still very prevalent. In a survey of sites by Antidote (n=55), the majority (89%) reported using existing patient database outreach to enroll trials, and 58% said it is their most successful recruitment method. Traditional advertising is used by 53% of sites, and 18% said that method is most successful for them.

More specifically in terms of success, 89% of sites reported that traditional advertising is at least somewhat successful for them, while 96% reported that existing database outreach is at least somewhat successful for them. Sites also overwhelmingly shared that both traditional advertising and existing database outreach were not difficult to implement.

However, just 27% of the sites surveyed reported being fully satisfied with their current recruitment methods. Almost a quarter of sites said they spend more than five hours a day recruiting for trials. Further, it can be hard to be too specific with these methods of outreach, which may explain why the number one patient recruitment problem for 87% of sites surveyed was that patients identified are not eligible for the trial being enrolled.

Digital Recruitment

We found that while 56% of sites use social media advertising to recruit, just 9% report it as their most successful method. In a world where the average person spends nearly 11 hours a day engaging with technology, clinical trial recruitment has a long way to go to catch up. Our online patient recruitment expert shared five best practices in a recent blog:

  1. Think from the patient’s perspective. They are interested in risks and benefits, the purpose of the trial, and the location of the site.
  2. Understand online platform advertising policies. These can be complicated, and you may need to call in an expert to ensure compliance.
  3. Get specific. Many online platforms offer interest targeting or can help you find a lookalike audience to reach specific groups.
  4. Measure and analyze. The great thing about social advertising is that you can always be testing and adjusting until you’re fully optimized.
  5. Keep up with new options. Digital marketing is a fast-moving, ever-changing arena, but keeping up with the newest offerings from various platforms may give you an edge.

It might sound overwhelming, but getting highly specific in your outreach might ensure eligible, engaged patients—and might save you money in the end.

An Inside-Out Approach

There’s another method to consider, as well, and it’s what I might call an “inside-out,” patient-centric approach. We know that as patients look for a clinical trial online, they often input details about their health in order to find the best match. If they don’t find a match, they ask to be alerted when one comes up. This means that clinical trial recruitment companies have large databases of patients who are very eager to take part in research. Importantly, these databases include health details that can help sites pre-determine who might be eligible.

So this patient-centric model would allow sites to browse through anonymized patient data, then get in touch with local patients who meet their study’s criteria and who are interested in taking part in research. Again, 87% of sites we surveyed said their number one problem with recruitment was that patients weren’t eligible. Here we have a very real, achievable solution to this problem.

Keeping the Patient at the Center of Site-Based Recruitment

We know that sites are frustrated with a lack of eligible patients, but it’s important to remember that patients are also frustrated with the inability to find a trial match. If a patient sees a newspaper ad and goes to the trouble of reaching out and being screened, only to find they are not a match, that’s not a patient-centric experience.

Sites can keep patients at the center by reaching out to those who are known to be likely eligible—through leveraging highly targeted existing database outreach, conducting specific digital marketing, and tapping into external robust databases that include health details.

Author: Nandini Nayar, Senior Vice President for Commercial Operations with Antidote