Patient recruitment: the heart of clinical research
It’s hard to believe that, in 2021, with our science-driven culture and with our vast technological awareness, 86% of clinical trials still fail to meet recruitment targets every year. In fact, a recent survey by Clinical Leader estimates that half of Americans may be completely unaware of clinical studies; meaning serious issues could arise for US-based pharmas when it comes to basic trial recruitment for their phase 1 clinical trials.
While this issue has been ongoing for several years now, the sincerity of the situation has never been more prevalent than today with the global scare of the COVID-19 pandemic. Just a few weeks ago, Swiss biopharma Novaratis halted coronavirus trials for their malaria treatment due to a lack of participation. This news follows months of deadlock across the industry, with Continuum Clinical’s study into the impact of coronavirus on clinical research finding, back in March, that 81% of research sites reported great amounts of unwillingness by patients to continue with trial participation.
With a rise in safety concerns around visiting trial sites and other healthcare locations, traditional, leaflet-in-hand/letter-through-the-door patient recruitment might soon be eradicated. It’s now up to research sites to seriously reconsider their trial recruitment metrics and, in doing so, evaluate the solutions that patient recruitment companies can offer.
Out with the old
The thing with traditional trial recruitment metrics is that they only ever work when they are carefully tailored to the individual’s needs; and given that most research sites don’t have the time or money to do so, this becomes a bit of an impossibility. The leaflet at the local clinic is only ever brought to the patient’s attention by the healthcare provider, and this interaction is only made possible by the research site’s ability to convince the healthcare provider to do so. Consider yourself a smooth-talker? Think again. A recent report by Tongue et al. found that 75% of the researchers surveyed believed that they communicated satisfactorily with their patients, yet only 21% of the participants reported satisfactory communication with their doctors.
Making a leaflet for the doctor’s clinic seems like such a straightforward recruitment strategy; yet, it is riddled with pitfalls. There are many hidden complications including several levels of interaction that require not only a clear and thought-out communication strategy but excellent salesmanship to ensure the patient’s participation. Okay, so the leaflet at the clinic isn’t a viable option; but what about postal advertisements? Research sites can rule this method out too. In fact, figures by the Direct Marketing Association estimate the response rate to leaflets at a poor 1%.
In with the new
Time and time again, research sites pour all their capital into perfecting their patient recruitment plans and, in doing so, fail to form a strong enough patient engagement strategy. The key to successful clinical trial enrollment actually comes from how you approach patient engagement; and this is something that patient recruitment companies excel at. While paying your way through trial recruitment has more upfront costs, patient recruitment companies ensure that research sites get their money’s worth with less chance of failure and less hidden pitfalls than traditional metrics.
Not only this, opting for patient recruitment companies alters the scope and speed of any clinical trial. The first and foremost thing to note when considering clinical research recruiters is the rate of change in the technologies used in clinical studies. The recent rise of ‘big data’ emerging from the healthcare industry means that clinical research of the future might have to employ tech to process their findings (for more information on ‘big data’, check out our guide to the topic here). Ultimately, this means that how we understand patients’ wants and needs has fundamentally changed over the course of just a few years; and so the old days of paper surveys and postal questionnaires are practically behind us.
This also means that the traditional ideas of how certain groups in society communicate have now become stereotypes. According to the latest figures produced by Facebook, 62% of online seniors (that is, people 65 or older who regularly use the internet) have a registered profile on the site. This indicates that the older population is now more tech-aware than ever before; and so, patient recruitment - especially for Alzheimer’s clinical trials and research on dementia - should look to invest in digital marketing technologies to appeal to potential patients.
Similar can be said about patient engagement in the near future. If we can now track what potential patients want and need from clinical research, we most certainly can carefully monitor their engagement with a trial currently underway - something that was a practical impossibility at one time or another. In recent years, advances in technology have meant that patient-reported outcomes can be accurately assessed and any non-compliance can be detected relatively easily.
For research sites running clinical studies over extensive periods of time, it has always been a struggle to avoid non-compliance. Some of the most common issues in this area concern compliance deficiencies in the following: participant safety concerns, clinical protocol deviations, informed consent violations, and failure to maintain adequate case histories. Yet, with the help of digital monitoring apps, these could soon be problems of the past. Data collected from patients through these apps can be carefully organised and monitored for any significant changes that could endanger the patient’s welfare or the integrity of their data during the trial’s run.
Following the same line of thought, new methods of attracting potential patients and monitoring their progress must mean new methods of communication in general. It’s of the highest importance that, while digitization has the potential to bring a lot of benefits for research sites, that we remember communication is a two-way process. Therefore, it is vital that research sites use these platforms not merely as a means to observe their subjects and their behaviors, but as a prime opportunity to survey their patients’ thoughts and fears. In this, lies the key to improving the industry’s anxiety over the researcher-patient relationship that sees around 85% of trials fail to retain patients until the end of a study.
A recent report by Forte Research found that 48% of patients who dropped out of the clinical studies surveyed said they were primarily motivated by “myself” to stay enrolled. If we compare this with the 20% who listed “their relationship with the study staff” as a motivational factor, it’s clear that feelings of isolation seem to be a common occurrence among patients. By providing an online or in-app platform for patients to discuss their worries, research sites can utilize the full extent of benefits provided by technology that, ultimately, works to shape clinical trials into comfortable and patient-friendly environments.
Here at Citruslabs, we've created the ideal patient recruitment dashboard to help any researcher improve their current metrics. With over 3 million patients on record, we ensure research sites are connected to a thoroughly educated and engaged pool of participants; so, it is no wonder why we have such high patient confidence! Now, we would say that other models are available - but this would be a lie. In fact, unlike that offered by other patient recruitment companies, our easy-to-use dashboard is the first-of-its-kind for the market; giving researchers a unique insight into their patients’ wants and needs via industry-leading technology. The future of clinical recruitment starts here.
Interested in finding out more? Get in touch with us here, and check out our archives for all our top tips and tricks on running successful clinical trials in today's constantly changing industry.
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