5 common clinical trial patient recruitment challenges and solutions

A lot can go wrong in clinical trial patient recruitment, leading to delays for up to 80% of all clinical trials. From underperforming sites to unresponsive patients, there are solutions to the most common patient recruitment challenges that can help accelerate your trial and ultimately beat your deadlines. Try these approaches if recruitment problems are putting the success of your trial at risk.

Problem: Your research sites are underperforming.
Solution: Diversify your patient recruitment approaches.

Clinical trial recruitment rate calculations rarely take challenges at the site level into account. Nearly half of all clinical trial sites under-enroll, and in the worst cases, 11% of sites in a given trial fail to enroll a single patient. Even with an effective site selection process in place, unforeseen issues at sites can slow recruitment. Patient databases that haven't been updated may have outdated and unusable contact information. Competition from other trials recruiting near a site can also have a negative impact on site performance.

It's important to diversify your approach to patient recruitment early on in the process. Identify clinical trial patient recruitment companies you're interested in working with, and engage them for digital advertising or partnership opportunities before sites begin underperforming. Having a diverse approach from the start allows trial teams to beat their timelines.

Problem: Patients being referred to you aren’t qualified for your study.
Solution: Work with a recruitment company that has access to more specific data.

Clinical trial protocols are increasing in complexity. For example, researchers may look for patients with specific lab values based on blood tests – information patients are unlikely to know on their own. This typically means that research sites screen fail more patients, leading to delays in recruitment and making goals harder to reach.

To speed the process of identifying patients with complex eligibility criteria, consider working with a patient recruitment company that has access to additional layers of data beyond a diagnosis. Knowing the medication patients are taking, or even the results from recent blood work, can make it much easier to connect with the right patients. Having a lab partner in your back pocket for recruitment improves the patient experience, lifts the burden to participate, and the quality of patients referred to your sites. Partnerships like this are now even more important, as many trials have become siteless as a result of the COVID-19 pandemic.

Problem: Patients become unresponsive before they ever reach your research sites.
Solution: Get support on patient and site follow-up.

Even if a patient is interested in taking part in your trial, there are still plenty of opportunities to lose contact in the course of their journey from learning about your trial to randomizing. Patients may miss an email or phone call, or be unable to attend a site visit for additional screening.

Reaching out to potentially interested patients and conducting site screening keeps staff busy enough, and it can be challenging to find time for following-up with patients who have fallen off the radar. Working with a recruitment agency that also offers site and patient follow-up services can help you successfully progress interested patients to the next step. Automated follow-ups through digital advertising, emails, calls, and text messages give patients multiple opportunities to set up a site visit. For patients who miss a visit, it's important to reschedule if they're interested, or find out more information about their cancellation that can be used to improve targeting. These services reduce site time while moving interested patients forward in the process.

Problem: The patients you find live too far from your sites.
Solution: Offer travel services, virtual visit opportunities, and adjust your targeting.

If the patients you're reaching aren't able to make it to your research sites, there are a few solutions that can help. First, communicate with the sites or recruitment companies conducting your outreach about whether targeting can be adjusted to narrow the radius in which patients are being reached. Several different factors impact how far patients are willing to travel for a clinical trial, such as the visit schedule and how symptoms impact patient energy levels and mobility. Paid clinical trials, compensation for travel, and patient travel services can help make it easier for your patients to take part. 

Virtual clinical trial opportunities that patients can participate in from home have become more mainstream due to the COVID-19 pandemic. This promotes equity in who can participate and also encourages an improved patient experience. Participating in a traditional clinical trial can be difficult. Obstacles can include multiple visits to clinical trial sites over extended periods of time or visiting sites that are not always conveniently located. Technologies like telemedicine simulate the kind of face-to-face interactions that help build trust between patient and provider and lower the burden on the patients. At the heart of it, alternative trial models lower barriers to recruitment. If a study is largely virtual, location becomes less of an issue, and clinical trial recruitment companies can cast a much wider net to speed up the process. 

Problem: Your outreach efforts aren't generating interest in your trial.
Solution: Work with a recruitment company that has experience in your specific condition area.

In surveys regarding patient attitudes toward clinical research, there are recurring themes: Patients are largely driven by altruism and an interest in advancing research, for example. But a patient survey revealed that motivations can also vary widely among different condition areas. For example, asthma and allergy patients were more likely to say that receiving payment was important to their decision to participate.

If your outreach materials aren't bringing in interest for your trial, they may not reflect the needs or interests of your patient population. One of the best ways to learn more about your patient population is through researching the ways that they interact with their peers. Try searching through an Instagram hashtag to get a real picture of what patients are talking about, what matters most to them, and what phrases and terms they use. A patient recruitment company with experience recruiting for a range of conditions can help you create effective outreach materials that speak to the unique reasons your patient population may be interested in taking part.

Clinical trial patient recruitment companies use a range of methods, from digital advertising to community partnerships, to find the right patients for your trial. Antidote has proven successful in saving sponsors recruitment time, while providing a positive experience for patients.