Clinical trial recruitment is the process to identify, screen and recruit participants for clinical trials. The cost is high, and speed is typically slow.
“Globally, 90% of all clinical studies fail to meet recruitment deadlines and need to extend their enrollment periods” (1).
There are multiple reasons for the challenges related to recruiting trial participants.
Studies show that 50% of patients simply do not know what a clinical trial is (2). Thus, a hygiene factor is to “sell” to patients the potential benefits of clinical trials and explain - in layman terms - the nature of a clinical trial.
For those patients, who do know what a clinical trial is, only a minority is aware of the available clinical trials when considering treatment options. For example, within oncology only 16% of relevant patients are aware. In addition, a majority of Primary Care Physicians also lack an overview of clinical trials avaiilable and do not consider clinical trials a treatment option (3).
When patients look for clinical trials, 43% use search engines, such as Google (4). However, most clinical trials websites do not have a targeted search marketing strategy. Websites often do not rank organically for therapeutic and condition specific key words, neither do they have an active paid search strategy.
Health literacy is lacking across populations. Nevertheless, clinical trial websites abound with industry technical jargon and healthcare lingo, which is typically incomprehensible for patients and caregivers.
When eligibility criteria get more advanced and the protocols get more complex and taxing for patients (and HCPs), the task of identifying and motivating patients for participation becomes more challenging.
Despite the above challenges, the potential for more efficient clinical trial recruitment solutions remains, as numerous studies show that for patients who understand the nature of clinical trial, the majority is interested in learning more.
Digital communication can address select of the challenges. Note that clinical trial communication needs to be improved by the Institutional Review Board (IRB) and adhere to FDA's regulation on recruiting study subjects in the US. In the EU new regulation was passed January 2022. Advertising should include the following (FDA):
Below are a few initiatives which allow a pharmaceutical company to increase the recruitment rate at a lower marginal cost than traditional channels.
1. Insights via research of digital behavior
As digital is the primary channel for patient research and engagement, map search and social behavior within a given therapeutic area to understand barriers, opinions, beliefs related to treatment and clinical trials. Also identify the digital whereabouts and influences of relevant patients. The insights will inform your clinical trial recruitment omnichannel strategy.
2. Omnichannel strategy
Define personas for patients and HCPs to systematically map the barriers and motivators related to clinical trials participation.
Typical barriers include:
• Perception of risk from abandoning existing treatment and/or embarking on new treatment
• Time consumption related to site visits and travelling
• Fear of medical tests
• Insurance unclarity
• Sharing personal health data with community
• Lack of trust in the industry and history of discrimination in certain population segments
Typical motivators include:
• Contribute to the health of others
• Find a better treatment for themselves
• Advance science and medicine in general
• Remuneration
• Being part of a meaningful community
The content strategy needs to be aligned with the specific barriers and motivators identified, and the channel approach, to the insights of digital research. A targeting strategy that merges persona attributes with the targeting data available across digital media is to be defined.
3. Execution
Content needs to be written in “plain” language which includes verbiage already used by patients. Content should be distributed across all relevant digital channels. A clinical trials website would typically be the hub within the overall clinical trial recruitment digital ecosystem. Also, traffic driving campaigns need to be activated, at a minimum featuring Search Engine Marketing (5), Facebook and key online influencer collaboration (PAGs online and individuals).
In sum, trial recruitment via digital allows you to:
80% of internet users have reported performing a health-related search in the previous year (6). Nearly 90% of older adults have used social media to seek and share health information (7). Social media can be used for ‘hard to reach’ groups that cannot be easily accessed through traditional methods. These include low-income populations, adolescents and young adults (8). Embedding your recruitment strategy in the digital lives of patients holds significant potential to lower cost and increase speed of recruitment. For example, trial recruitment for Refractory Gout study accelerated recruitment by 9 months by using patients’ digital footprint for targeting (9). Also, a study published in the European Heart Journal documented the relative efficiency of Social Media in clinical trial recruitment (10).
If you have any questions or comments, please feel free to reach out to us.
(1) Clariness, Enhance your clinical trial
(2) Couch, Importance of Clinical Study Websites
(3) LillyCOI, USA + Engaging Referring Physicians in the Clinical Trial Process, J Oncol Pract. 2012 Jan
(4) What Do Clinical Trial Participants Want?, TransCelerate BioPharma
(5) Google guidelines
(6) Doctors.com2020
(7) How to Use Social Media in Healthcare, Hootsuite2020
(8) A Scoping Review J Med Internet Res 2016;18(11):e286.
(9) AutoCruitment_Gout_CaseStudy,2020
(10) Using social media to recruit study participants for a randomized trial for hypertension, European Heart Journal - Digital Health, Volume 1, Issue 1, November 2020
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