Did you know that 85% of clinical trials fail to retain enough patients? Or how about that the average patient drop-out figure across all clinical trials is 30%?! Given the difficulty studies face in recruiting eligible participants in the first place, can studies really afford for those they do recruit to not be seeing the trial through to completion?
The truth is that many studies simply don’t pay enough attention to developing a detailed and effective patient retention strategy and this negligence translates into costly patient retention statistics.
Fortunately, creating such a strategy is not as difficult or time-consuming as it might first appear. Here are some practical tips for creating a patient retention strategy that functions effectively across all aspects of a clinical trial:
Plan Ahead
For best results, patient retention should never be just an afterthought. Instead, it should be a central focus from the very beginning, and a retention strategy included into the study design.
The best way for a sponsor to keep patient retention in mind during the design phase s to first consider the burden of participation that will be felt by patients and consider how the burden applies to each stage of the study. Once this analysis has been done, measures can be designed into the study to minimise the burdens while maximising the benefit of participation.
Once way to best identify the degree of the burden of participation, and to ensure that potential patient concerns can be addressed before they even arise, is to conduct focus groups with patients from similar previous studies or with patients in the same demographic as those who will be recruited.
While this proactive approach may be time-consuming in the short term, accounting for a patient retention strategy in the design stage of the study and taking a patient-centric approach to all aspects of planning will reap rewards in the form of increased retention in the long-run. It is also makes it more likely that a patient-centric attitude will remain central through all phases of the study,
Address Patient Concerns
Once the study design phase is completed and patient recruitment begins, another significant moment for patient retention occurs, that must be handled carefully in order to maximise retention. This occurs in the conversation between the investigator and the potential participant at which point consent is sought for the patient’s participation. This is the point at which the study is fully explained to the patient, and it is crucial that this is done thoroughly. Patients have a range of individual concerns, and reservations about participating, and so the investigator must work to listen carefully to the patient, understand their concerns, and then mitigate their fears whilst highlighting the benefits of participation.
Additional resources can be of huge benefit to this process, with DVDs, leaflets and newsletters used by many studies to ensure that potential participants are well-informed before they consent to participation.
Dealing with participant concerns at this initial stage is key to preventing patient drop-out further down the line, and creating a meaningful dialogue between investigator and patient means that further participant worries can be more easily identified and eased if/when they arise.
Maintain Communication
During a patient’s participation in a study, a good retention strategy must pay equal attention to both the time the participant is physically visiting the site, and the period in-between visits.
In-between visits, when the participant is not physically present, maintaining effective communication is key, and technology plays a key role here in any successful retention strategy. Many study sites maintain contact with patients via telephone, and this has proven effective as a means of maintaining a strong relationship between investigator and patient, but SMS alerts can also be a cost-effective and strong alternative or supplement. Dialogue at this time should not just focus on reminding the patient of upcoming visits, or about medication, as it also presents a chance to revisit any concerns the participant may have and ensure that their experience is comfortable and pleasant.
Further to this, social media is an invaluable tool that can be used to effectively communicate study updates and maintain communication with large numbers of participants simultaneously. Creating updates can be time-consuming but posting regularly serves to reinforce the relationship between the study sites, investigator and participant, and keeping patients informed is key to retention.
Some sites have also increased their retention through providing participants with extras such as calendars which remind them of site visits, monthly newsletters, contact information for study staff, and even personal touches such as birthday cards!
Make Visits Pleasant
Site visits are a further key opportunity for building a relationship with patients and providing a positive trial experience that leads to the participant remaining in the study.
The hassle of getting to and from sites is often a barrier to participation, so ensuring the site is easily accessible and ensuring that patients have smooth travel to and from the site can make a huge difference to the way the patient perceives their experience.
Similarly, site-visits are the best opportunity to develop good relationships between investigator and patient that will shape the clinical trial experience. The investigator should make every effort to ensure the patient’s comfort at all times and answer any questions or concerns they may have.
Ultimately, a patient retention strategy should not be simply be developed as the study progresses. It should be devised in the design phase and evident in all aspects of the study from recruitment to participation to completion. Adopting patient centred practices focuses staff on providing a positive trial experience for participants which will manifest in increased retention.
