5 New Rules for Clinical Trial Patient Recruitment

Since the first controlled clinical trial way back in 1747, researchers have needed patient volunteers to take part. We don't know how difficult it was for James Lind to find 12 sailors willing to try a treatment for scurvy, but we're sure he had to make a strong pitch that focused on the benefit to them as patients.

While the need for smart messaging may have remained constant, everything else about patient recruitment has changed, especially the way patients now hear about clinical trials through digital advertising. Our "new rules" for clinical trial patient recruitment, however, aren't just about technology: They also require that research teams engage patients every step of the way. In our experience, these five guidelines help us save trials time on patient recruitment while creating a positive experience for patients.

1. Get patient input as early as possible

Ideally, patients should be involved in the initial design of a clinical trial. Patient engagement ensures that a trial addresses real patient need, and that inclusion and exclusion criteria should balance scientific requirements with the real-world experiences of patients. Patient advocacy groups and health nonprofits are great choices for input on study design.

Patients can also help identify elements of a trial that appeal most to them and their symptoms, valuable information for developing outreach materials. In addition, some recruitment companies also work with patient influencers or other advocates for their support spreading the word about a trial opportunity.

Sponsors have, at times, been hesitant to engage with patient advocacy groups for clinical trial recruitment in particular, says Mary Rose Keller, VP of Clinical Operations at Heron Therapeutics.

"A lot of diseases have multiple advocacy groups. Sometimes sponsors have anxiety about being associated with one advocacy group versus another," she told Clinical Leader. "They also don't feel they can adequately serve all of the groups. And, let's face it, once you put a group together, they can become political in some way. That is something sponsors can be leery of."

Working with a middle man like a patient recruitment company that has relationships with patient advocacy groups can help sponsors access input from these organizations without ruffling feathers.

2. Include diverse messaging and imagery across all channels.

Related to the importance of including the patient perspective in trial design and recruitment campaign development, make sure your trial uses outreach materials that visually reflect the diversity of your patient population. Patients are more likely to connect with imagery that reflects them and their experience with a condition.

Before selecting a patient recruitment company, ask to see examples of their outreach materials from prior campaigns, and notice whether their images match the demographics of your target audience, and included a variety of options that spoke to a range of patient experiences.

3. Incorporate site-based recruitment alternatives from the beginning.

In an ideal world, research sites for clinical trials would already have all of the patients needed for the trial in their database, ready to participate. In reality, 37% of sites under enroll and 11% fail to enroll a single patient into a trial. Digital approaches and other clinical trial patient recruitment efforts shouldn't be a backup plan – they should be incorporated into your budget and planning from the beginning.

Online marketing is effective in part because it's simple to test out language and find messaging that resonates best with a given audience – but it also takes time. Short timelines for "rescue trials" give recruitment companies less time to gather data to find what works best, which can raise the cost of recruiting patients.

Activating site recruitment alternatives early on can also help sponsors shorten recruitment timelines. While simply meeting deadlines feels like accomplishment enough, meeting trial goals faster can move an entire trial schedule forward and bringing potential treatments to patients sooner.

4. Plan on your plans changing.

As critical as digital outreach can be to a patient recruitment plan, it's also a space that's ever in flux. Though Facebook is currently the most popular social network for placing ads, the company may be pivoting over to other revenue sources, like its messaging tablet Portal and even online dating.

Chances are, any new platform will include ads at some point, so it's important to plan for a range of outreach options – and for them to need adjusting, especially for longer trials. While the need for IRB approvals may limit options, patient recruiters can create flexible materials like banner ads that can be used across platforms. Recruitment companies with extensive experience in digital marketing also know to provide IRBs with a range of outreach angles, so they can optimize their campaigns and find the messaging that resonates best.

5. Consider end-to-end recruitment needs

Working with a patient recruitment company that also offers site follow-up services can also help improve the patient experience. If a patient fills out a pre-screener online but then doesn't hear about next steps for a few days, patients may feel frustrated or potentially lose interest in the trial altogether.

To illustrate the point in marketing terms, the website platform Hubspot revealed that companies who follow up with a potential customer inquiry within an hour are seven times more likely to have meaningful conversations with decision-making than those who wait longer. While the Hubspot study referred to business, people are people – when we express interest in something, we want to hear back sooner rather than later.

"I don't believe patients evaluate their medical care or treatment in a clinical trial any differently than their experiences with other service providers," Maura Snyder, director of Clinical Insights and Experience at Janssen, told Clinical Leader. "Their experience will always come down to good customer service."

In addition to creating pre-screeners and promoting your trial, some patient recruitment companies will also call patients to ask additional questions and help direct them to a nearby site, if they're eligible. Antidote also works directly with sites to learn about which patients make their site visits or become unresponsive so our team can offer additional support if needed.

Looking for patient recruitment support? Antidote uses precision recruitment to reach the right patients with the right message. Learn more about our unique approach.