How to Improve Patient Recruitment in Clinical Trials: Know the Process

Researcher meets patientAs you know, clinical trials drive medical research forward. But as experts in finding effective solutions to the clinical trial industry, we know it can take a lot of work to get qualified patients recruited for the study. From HIV treatment to peanut allergy therapy, much of the movement behind medical advancement is due to clinical trials – which in turn are fueled by successful patient recruitment.

Good outcomes in patient recruitment depend on a balancing act. Structure and flexibility, professionalism and personability, efficiency and thoughtfulness – these are just some of the supposed antonyms that make up the most successful patient recruitment process.

Here we examine the three major stages of patient recruitment – and the best practices to improve the process along the way. If you know what you need to do in patient recruitment, but you’re not sure how to make the most of each step, you’ve come to the right place.

Make Initial Outreach More Effective With New Efforts

Digital is the new normal these days, and clinical trial researchers would do well to take note. Consumer Health Online found that three quarters of Americans are looking up medical and treatment information online every month. In contrast, just 11 percent of clinical trials use social media for patient recruitment.

Clinical researchers should be taking advantage of this disconnect by finding ways to connect with patients on social media and in search engines. To a certain extent, the same rules for search ads and social advertising apply. For search ads, this means researching the keywords your target population will be searching and bid accordingly. For social ads, it means narrowing your field by being as specific with demographics as possible.

Ed Miseta, Chief Editor at Clinical Leader has a great guide for when ‘normal’ digital advertising rules don’t apply to patient recruitment. “Targeting the right audience with the right message on the right channels can make a meaningful difference in patient recruitment,” Miseta writes.

In other words, the advance of digital reach doesn’t mean you should give up more traditional recruitment methods overnight. The Tufts Center for the Study of Drug Development has critical insight on this front. Just over five years ago, the center reported that most clinical trials double their timelines due to issues with patient enrollment. The same study showed that just over half of clinical trials meet or exceed their enrollment targets. At the time, the report highlighted the lack of alternative recruitment channels (such as social media) as the critical factor. Four years later, another study found that physicians refer just 0.2 percent of patients to a clinical trial.

This duo of reports shows that outreach is a balancing act in its own right. Digital ads, traditional ads and physician referrals can all be effective recruitment strategies. It just depends on how you use them.

Achieve Conversion With a Streamlined Process

After putting your outreach in place, the next stage in recruitment is conversion. Getting people to engage with your initial screening – whether it’s over the phone or with an online form – is all about time, as with most things in life.

How long will it take potential patients to complete the initial screening? How much time passes between when they send an initial inquiry and you reach out with more information? How long between screenings? How much time and effort does enrollment take?

The answers to these questions will heavily impact the success of your conversion efforts. How to improve patient recruitment in clinical trials rests partly in streamlining the process. This takes shape in several ways.

First things first: ensure you maintain fast response rates to trial leads. If you have an interest form set up, treat it as an opportunity for instantaneous contact, not a backlog to be cleared later. “Call people immediately,” says Trialfacts CEO Nick Karrasch. “I don’t mean within an hour, I mean within a minute of them making that first inquiry.” Calling them right then will translate into the best success rate.

If that idea sounds a little overwhelming to you, be sure to put the tools in place that will set you up for success. Use an SMS alert system, such as Zapier, to alert you when new inquiries come in. You can then pick the phone up right then to confirm interest with the potential patient and schedule a screening. Another option is to set up an appointment scheduling system – something patients can use to schedule their appointments more easily (and save you time in the process). Even then, we still highly recommend reaching out to the patient with a quick call or text to confirm the screening appointment and offer your help in the meantime. In fact, that personal follow up is necessary if you want to reach a 100 percent contact rate.

Throughout this process, keep volunteer contact timely. When setting up an appointment for the initial screening, be sure it’s within a few days, not next week or further down the road. One of the main reasons potential patients drop out before the study is because what was a priority for them loses its urgency. They may lose interest – or they may just get busy. You want to avoid either scenario.

Once that conversion is complete, don’t drop the ball on keeping patients engaged. Another pitfall many researchers fall into is making it too difficult for patients to participate in the study. Remember that they are volunteering. “If there are a lot of hoops for them to jump through, you’re going to have a high drop out rate,” says Nick.

Sending a 20 page consent form via email is the single most effective way to get people to not participate in your study. Instead, save the more intense paperwork for when the patient comes to their initial study visit. Potential participants can read it 15 minutes ahead of their appointment and have the researcher available to answer any questions or concerns.

The key phrase here is to keep the middle stages of patient recruitment streamlined. For your sake and for theirs.

Keep Enrollment Rates High With a Personable Approach

The final stage in patient recruitment is enrollment – keeping patients engaged so they are set to move forward with the clinical trial.

If outreach and conversion are about strategy and efficiency, enrollment is about personability. The more personal your recruitment approach, the better.

Yes, you need to keep your team efficient. Yes, you need to track your outreach and conversion. But never conflate efficiency with pure mechanical optimization. A high conversion rate – getting people to fill out that form or make that phone call – is important to the recruitment process. But a personal touch that encourages enrollment and participation is even more important. After all, your goal in improving patient recruitment isn’t simply to get the highest number of participants from the outset. It’s to recruit qualified patients that will stick with the study.

Taking a personal approach to a large scale and largely technical recruitment campaign may be easier said than done. So how can you keep things personal in practice while balancing hundreds (or thousands) of phone calls, appointments, and feedback?

Take it one step at a time, for starters. Nick makes it clear that all the touchpoints of the recruitment process – from your initial inquiry to a personal screening – should be treated as a two-way street. You assess potential patients for the study, and they assess your study to see if they want to participate in the clinical trial. Nick says that the phone screening and clinical screening touchpoints see the highest drop out rate – often because recruiters lack that personal touch.

“If you’re doing a fantastic job at reaching people via the phone, but doing a poor job cultivating interest during the phone screening and connecting on a personal level, then you’ll have a lot of people drop off at that stage,” Nick says. It’s about showing that you care for that individual person by “connecting on a personal level,” not “sticking to a script.”

In other words, taking a personable approach doesn’t mean you have to do away with call sheets and appointments. It simply means bringing sympathy, respect, and trust into the mix.

Speak to the ways your clinical trial will benefit the patient and their family. Encourage questions. Be honest.

We’ve said it before and we’ll say it again: the difference between successful and unsuccessful researchers is that those successful in recruitment understood the importance of developing a relationship with their volunteers. You’re recruiting for a clinical trial, but clinical should at no time describe your demeanor.

Bottom Line: Effective Patient Recruitment is a Balance of the Personal and Strategic

How to improve patient recruitment in clinical trials is not about one single thing. It’s about striking the balance that works best. You want your recruitment process to be personable on the front end, and equally efficient on the backend.

“Because of the multiplicative effect, enrollment is only going to be as good as your weakest step,” says Nick. “Any breakdown in your funnel means you’ll have a large drop out rate.” This could mean you’re not making that personal connection that potential patients need to see the value in your study. It could mean you are using the wrong digital advertising channels for your audience without knowing it. Or it could be that you’re not following up quickly or consistently enough to capture your potential participants when they are most interested.

Unlike most tech pieces these days, this article is not about that one simple trick or that quick fix. Given this overview, we are instead suggesting a review of your entire process from start to finish to improve patient recruitment in your clinical trials. Find out what is working for you and what isn’t. Only once you know the process can you improve it.

Interested in improving your patient recruitment process step by step? Get started with these additional guides from Trialfacts:

  1. The Volunteer-Researcher Relationship
  2. Does Social Media Recruitment Make Sense for My Clinical Trial?
  3. Contacting Volunteers

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