The National Institutes of Health (NIH) recently reported that in the US, 80 % of clinical trials do not adequately meet the projected patient recruitment timeline. Frequent delays result in depletion of resources and an increase in trial costs. More effective ways to conduct clinical trial recruitment are in constant demand as delays in completion impact the remaining market life of a product before it goes off patent.
Recruitment is a complicated process primarily because it involves a lot of people and resources across numerous investigator sites. Physicians, research staff and sponsors are all involved in the targeting and screening process. Recruitment targets are measured against aggressive timelines which if not met can result in the cancellation of a trial altogether.
Companies providing clinical trial recruitment, such as clinical trial organizations (CROs) and patient recruitment organizations (PROs), enroll patients who meet protocol requirements and usually require immediate treatment. These companies have relationships with hospitals and research institutions but often more efforts are needed to recruit an adequate number of patients. Despite efforts by CROs to use new methods to bring awareness to hundreds of potential new participants, poor patient recruitment is still a common problem.
Clinical trials are performed to test the efficacy of drugs, treatment protocols and medical devices on a defined patient population. Patient recruitment efforts use all the tools possible to attract the right patients but often times it is still not enough as recruitment efforts focus largely on untreated and newly diagnosed patients. Even the enticement of free medical care offered to the uninsured or those who cannot afford treatment fails to deliver the needed results. Delivering the clinical trial message and creating patient awareness and education are major factors that weigh heavily in the recruitment equation. The recruitment process is ongoing, while patients are screened and then those that are qualified are included into the trial until the trial target is achieved.
New approaches using digital recruitment has add to the success of patient enrollments. Internet savvy patients who are seeking trials can identify themselves as possible candidates. Digital media has become a cost effectively channel that draws awareness to target patient populations across numerous pathways.
The effective use of social media as a recruitment tool requires dedication and knowledge of the rapidly evolving digital landscape. This method works well because it offers effective segmentation and reach to a large number of patients. Strict study protocols quickly reduce eligible trial candidates, so large patient populations are needed to extract the right study targets. Weekly e-mail messaging programs, messaging alerts on Twitter and Facebook, wall postings and patient portals can throw a broad net over large numbers of interested patients.
Lastly, efforts to recruit patients into clinical trials are being extended through direct to physician messaging. While many specialists are not interested in referring their patients into a clinical trial for a concern of losing the patient, there are primary care physicians who do not share that concern. Large numbers of patients who are normally referred to specialists for needed care can be directed to a clinical trial opportunity should trial awareness exist at the provider level. This type of trial provider awareness I being generated through electronic health records (EHRs) where targeted messaging that informs providers can redirect patients into a trial before a specialty referral is given to the patient.
Advances in clinical trial patient recruitment are progressing rapidly as real time targeting and messaging becomes more ubiquitous within the rapidly evolving healthcare communication ecosystem.