A 2014 study from Clinical Trial Connect found only 20% of clinical trials met their recruitment deadline. These delays increase costs, drain resources, and extend the implementation of evidence-based outcomes into translation and practice. The challenges in recruitment are complex and involve multiple stakeholders, including investigators, patients, hospitals, administrative staff, sponsors, contract research organisations and clinical trial research teams.

Possible Solutions to Participant Recruitment

Researchers now include consumers in the development stage of research, including involving consumers as members of advisory panels, and in the design of protocols, Patient Information Sheets and Consent forms, and grant applications. Consumers can also assist with communicating clinical trials results to study participants and community groups.

Best Methods in Patient Recruitment

  1. Know your target audience: who is the target population, demographics, where are interested persons likely to seek information on a clinical trial. Use this to identify local hospitals/clinics, engage allied health, or use EMR.
  2. Develop a marketing plan that reaches the target audience and their preferences.
  3. Develop mechanisms to pre-screen and screen potential patients. You can have a screening process in place via dedicated recruitment team at your site or facility, through email contact or research staff. Prepare a thorough screening sheet based on the inclusion and exclusion criteria contained in the protocol. Ensure medical expertise is available to allow staff to seek answers (if required) prior to a screening visit being booked. Consider cultural and language barriers of your patients.
  4. Fast-track the process for screened patients: book an appointment at the site, send a confirmation email to the patient with relevant information including date and time for appointment, map/directions to the study site, parking instructions, pre-visit instructions, and study information (some sites send the Informed Consent to allow the patient to review prior to their appointment). Contact the patient prior to their visit and confirm appointment.
  5. Develop and implement a tracking system for all referrals and booked patients.  Always ensure patient confidentiality and privacy.

Improving Patient Retention

The goal of recruitment is a patient’s successful completion of the clinical trial. Protocol compliance is to ensure the standardised collection of robust data.

Ensure you:

  • schedule appointments appropriately, send reminders, use open communication
  • use reminders to complete patient diaries and/or interviews
  • implement communications that streamline the information flow and provide after-hours support for patients, follow up with patients, appointment rescheduling, and sharing information directly with trial coordinators.

Approaches to Improve Your Patient Recruitment in Clinical Trials

  1. Review the protocol inclusion/exclusion criteria
  2. Reduce the number of non-standard of care assessments
  3. Engage with and educate external referrers
  4. Use a clinical trial refer app
  5. Review EMR – sit in on clinics
  6. Spread the word to colleagues
  7. Share trial information on hospital notice boards
  8. Advertise on your website
  9. Use social media groups
  10. Review patient screening sheets for screen failures – review site recruitment rates
  11. Develop and implement an action plan to reduce patient screen failure
  12. Create a toolkit using flyers, inclusion/exclusion pocket cards, patient brochures
  13. Create newsletters and communication strategies
  14. Share the enrolment process and success of high enrolling clinical trial sites

Initial Contact

The key to success for clinical trials may be in how a participant is initially contacted. After all, without a successful initiation, a participant will not join a trial.

Digital Recruitment

As consumers and patients increasingly turn online for medical and treatment information, digital recruitment campaigns have become the new standard in clinical trials.

If you are using social media and search engines, it is important to research targeted keywords for your patient populations. For social media advertising, be specific with which demographics you are targeting: you need to send the right message to the right people.

Clinical trial apps like ClinTrial Refer can also provide fruitful opportunities for recruitment.

Ultimately, you might need to enlist some help from a person with digital marketing experience.

Use a patient database

Evaluate your own patient database. Alternatively, your site might have designated staff for recruitment pre-screening, who can connect patients with clinical trial opportunities.

Share your trial information

Patients respect their clinicians and might prefer to hear about clinical trial opportunities from them. Consider putting together materials about your trial designed specifically for doctors and other healthcare professionals.

Use pre-existing relationships between your site and local hospitals or general practices to spread the word. Meeting with them face-to-face, or connecting with doctors at conferences or workshops can be a valuable way to get the message out.

Connect with community and patient advocates

Organise to present at local patient support groups, community groups or hold a stand at a community fair.

Engage a clinical trial patient recruitment company

If you lack the resources to undertake recruitment, engage a recruitment company. Meet with several to discuss your budget and needs; they may offer digital advertising, access to a database or connect you to a not-for-profit organisation that undertakes work in the therapeutic area being researched.