25+ useful clinical trial recruitment statistics for better results

Oftentimes, clinical trial enrollment statistics paint a grim picture of the medical research landscape. A frequently-cited statistic is that approximately 80% of clinical trials are delayed or closed because of problems with recruitment, and there are other troubling statistics such as:

  • 9 out of 10 trials ultimately double their original timeline in order to meet enrollment goals
  • 11% of research sites fail to enroll a single patient
  • Clinical trial participation rates vary from year to year. Worldwide, 105,808 people participated in research in 2015, dropping down to 25,941 volunteers in 2016.
  • Delays can cost sponsors between $600,000 and $8 million for each day that a trial delays a product’s development and launch
  • Screen failure rates are significantly costly for sponsors and the cost (on average) across the industry is roughly $1,200 per failure.

Thankfully, these participation statistics aren’t where the story ends. Gaining insight into the patient perspective around medical research can help industry professionals better understand why patients do (or don’t) participate, and help research teams better engage them.

Organizations such as the Center for Information and Study on Clinical Research Participation (CISCRP) have contributed significantly to research in this area, and Antidote has conducted our own research as well. In addition, Antidote has worked with SCORR Marketing and our nonprofit partners to survey 4,000 patients living with various conditions and from a range of demographic backgrounds in order to gain insights into patient preferences and perceptions by condition area. We hope that our findings can help research teams have better conversations with patients around clinical trials, and help guide sponsors and sites to create studies that are designed with patient centricity in mind.

Except where cited, the statistics that follow come from research conducted by Antidote.

Trust in clinical trials statistics

Many patients who are considering joining a clinical trial are participating for the first time, and gaining an understanding of the research process as they go. Before enrolling, it makes sense that patients want to weigh the risks against the benefits — but how can we present this information in a way that patients will connect with most?

In our research, we found that simply having the opportunity to talk with doctors, nurses, clinical trial coordinators, or even fellow patients involved in the research made a significant difference. Our research shows that:

  • 92.7% of oncology patients say it's "important" or "very important" to talk with the doctors involved in clinical research before joining a trial
  • 90.4% of chronic disease patients said it was "important" or "very important" to talk with the clinical trial coordinators and nurses involved in research
  • 86.8% of oncology patients say it's "important" or "very important" to talk with other patients like them before joining a clinical trial. In our survey, this was more important to oncology patients than it was to patients living with chronic/acute or chronic diseases
  • Non-white individuals said talking with the hospital or company responsible for the research was more important than did their white, non-Hispanic peers (82.8% v. 73.8% and 77.3% v. 73.4%, respectively).

These numbers underscore the fact that providing patients with an opportunity to communicate with those directly involved in research can help build trust. For cancer patients in particular, talking with fellow patients can be very important to their decision-making process as well. In scenarios where these things are not possible, it can be advisable for sponsors to include information on the rationale behind a study in outreach materials, or incorporate patient testimonials throughout materials.

Additionally, providing detailed information regarding the informed consent process can also help patients feel more comfortable about participating in research, as they understand that it’s possible to leave a clinical trial at any time, for any reason. If a placebo is being used, it's important to explain the likelihood that they will receive it. Some studies offer the active drug to every participant if it's found to be effective, another benefit that should be highlighted if it applies.

What role does clinical trial protocol play in patient recruitment?

When clinical trials place too much burden on a participant, enrollment numbers tend to suffer — and in recent years, trials have certainly become more complex. A Tufts Center for the Study of Drug Development Impact Report found that the total number of endpoints in a protocol increased 86% between 2001-2005 and 2011-2015. Protocol complexity is one important factor that has contributed to patient recruitment challenges — as trials become more specific, the patients needed become more difficult to identify. 

Scientific needs aside, there are protocol changes trial teams can make that have little-to-no impact on the scientific integrity of a trial. Research teams should carefully consider how trial length, number of site visits, and specific medical procedures will impact the patients and influence their decision to participate. In our research, we found that: 

  • For patients with chronic/acute conditions, 93.6% said it was "important" or "very important" to know that they'll be able to complete the entire trial 
  • Over 92% of patients in all categories said it was "important" or "very important" for them to know they would be willing to undergo the medical procedures or tests in a study

Logistical and location-related issues create another barrier to clinical trial participation. An estimated 70% of potential clinical trial participants live more than two hours away from a study center, which can lead to significant travel time and life disruption if frequent site visits are required. 

Our research found that providing logistical support was most meaningful for those with chronic diseases, as limited mobility is often associated with these conditions. Findings also included:

  • For all groups, having home visits for some or all of the trial check-ins ranked last in importance. However, individuals living with chronic disease were significantly (p<.01) more likely to say this was "important" or "very important."
  • Those with chronic/acute and chronic diseases also thought it was more important to have equipment to track or monitor their symptoms than their peers living with cancer did (p<.01). 
  • When analyzing results by race, home visits appealed more to Hispanic and non-white individuals, compared with non-Hispanic and white survey participants (62.4% v. 40.2%, p<.01 and 58.5% v. 38.4%, p<.01 respectively).

To increase patient participation with these statistics in mind, sponsors can consider working with sites that offer home visits, and incorporating technologies such as fitness trackers to monitor data remotely, which can reduce the burden on the patient and allow for more accurate data collection, too.

Diversity in clinical trial recruitment statistics

Historically, minorities and people of color have been under-represented in the medical field, and clinical trials are no exception. This means that traditionally, clinical trial participants have not closely matched the demographics of the real-world population, which can lead to a lack of accurate data. For example:

While a lack of trust between communities of color and medical institutions is often pointed to as an explanation for these statistics, this may not be the biggest issue at hand. In fact, our key findings point to logistics as being a main concern, as illustrated by the following:

  • When analyzing results by race, home visits appealed more to Hispanic and non-white individuals, compared with non-Hispanic and white survey participants (62.4% v. 40.2%, p<.01 and 58.5% v. 38.4%, p<.01 respectively). 
  • Relative to white individuals, non-white individuals are more likely to partake in an observational trial. The same is true for Hispanic patients and women. 
  • Hispanic patients and women were also more interested in participating in observational trials, compared with white and male respondents.

Utilizing tools and technology that reduce the number of site visits — such as electronic patient-reported outcomes (ePRO) and home visits — may improve trial enrollment for the patients that study teams have the most trouble reaching. And, while it's important to increase trial participation in all types of trials, our findings suggest that engaging diverse communities in observational trials may offer a "gateway" into greater research participation in general.

Clinical trial recruitment through social media statistics

The healthcare industry is often slow to adapt to new technologies, and clinical trial patient recruitment technologies are no exception. A few key statistics around clinical trial recruitment and social media highlight that advertising is not the main approach study teams use to attract patients to trials — and advertising isn't really most patients' ideal way to find out about research, either. 

  • According to research conducted by CISCRP, just 5% of clinical trial participants heard about clinical research studies through online patient communities, and 16% heard about it from advertisements in general. Younger people, however, were more likely to have first learned of a clinical trial from online patient communities or through social media.
  • 73% of patients would like to hear about clinical trial opportunities from their doctor's office.
  • 42% would like to hear about trials from advocacy groups and nonprofit organizations.
  • 21% of patients would like to find out about trials through advertisements (printed, online, radio, TV).

Though this shows that patients often prefer to hear about clinical trial opportunities from their doctors, this doesn't always happen. In our survey, only 32% of patients reported that their doctors had ever shared information with them about clinical trials. 

Meanwhile, more patients are using social media than ever before. There are over 3 billion people actively using Facebook, Instagram, WhatsApp or Messenger each month. Users include members of all age groups, and other social media platforms like Twitter, Instagram, Snapchat, and TikTok continue to engage daily users. And when users are online, they're often talking about their health. In a 2019 Pew research survey, it was found that 80% of internet users search for health information online.

Sophisticated online targeting can make it easier to identify patients who are already interested in health topics. Hearing about trials from social media platforms may not be a patient's first choice, but if clinical trial patient recruitment companies can present trial information online in a meaningful way, the evidence shows that patients are likely to engage with it.

Understanding how to recruit patients for clinical trials successfully requires a nuanced approach to communicating with patients — and considering how patient preferences may differ due to factors such as race and demographics. If you’d like to learn more about how we can help you apply these findings to your clinical trial recruitment, get in touch today.