Retention strategies, trial site evaluations and dedicated budgets should be used to recruit patients to, and keep them in, clinical trials, according to research.
Patient recruitment is a significant issue for biopharm and contract research organisations (CRO). Slow recruitment rates can lengthen time to market, leading to loss of revenues. Consequently, it is important businesses adopt best practices to patient recruitment and retention.
Cutting Edge Information has compiled a list of these strategies based on survey responses and interviews with biopharm and CROs. Outsourcing is one strategy , but other options are available for companies keeping recruitment in-house, or CROs and recruitment vendors.
“The most effective way to improve patient recruitment, nearly all survey respondents agree, is to conduct a thorough evaluation of sites and investigators”, wrote CEI. Performing this review gives trial managers an understanding of the recruitment capabilities of a potential site.
Sites using electronic medical records (EMR) are preferable because they allow evaluation of the patient population and help physicians in recruitment. A site’s research history and capabilities should also be assessed.
Recruitment budgets & patient motivation
CEI recommends firms plan for patient recruitment by allocating sufficient funds in the study budget to overcome challenges. Despite the importance of recruitment, and the potential bottleneck problems create, 11 per cent of respondents have no specific budget for the task.
Recruitment budget can be used in a variety of ways, including hiring a specialist or deploying creative campaigns. “Whatever the methods used, the companies that support their sites’ efforts with good recruitment campaigns, fuelled by appropriate budgets, find more success”, wrote CEI.
Firms can more effectively use the budget if they understand the factors that motivate people to participate in clinical trials. CEI found altruism is the primary factor and suggests incorporating the feeling of helping a larger course into study advertising may be beneficial.
Recruiting patients is only part of the process though. Up to 30 per cent of patients drop out of trials, according to CEI, but strategies can be put in place to maximise retention. CEI found that 36 per cent of large pharma use retention strategies, compared to 67 per cent of CROs.
Patient dropout is a particular problem for long trials, making it essential to include a retention strategy in the protocol. Respondents to the survey said making patients feel special is the most important aspect of patient retention.
Achieving this requires an understanding of the physical and emotional aspects of trial participation. Survey respondents gave examples of giving patients in diabetes trials a cookbook to help cope with dietary restrictions and sending birthday cards to all participants.
Patients should also be engaged in the trial. Sending a newsletter detailing the trial’s progress and creating an online area where patients can share their experiences can achieve this.
Other techniques include reminders, by phone, mail, email or text message, and giving patients printed materials detailing dosing, follow-up visits and answers to frequently asked questions. Transport support and follow-up home visits may also be useful in some cases.