3 Patient recruitment strategies in clinical trials

8 February 2024 by Joseph Yeomans, VP Marketing & Dilek Denizli, VP Patient Recruitment Strategy

If you’re reading this content, then you’re probably already all too familiar with the traditional stats on the impact of underperforming patient recruitment, including everyone’s favorite, “80% of clinical trials fail due to insufficient patient recruitment”. Unfortunately, it’s true.

While this is true, more clinical trials are being run every year, in fact the number of clinical trials being run globally is increasing exponentially. In 2015, clinicaltrials.gov reported 181,221 trials registered, in just 5 years, this grew by 79% with 325,747 registered clinical trials; today, in 2024 there are currently 477,237 registered clinical trials. Some could argue that it’s a matter of spreading your bets, as opposed to dealing with the root of the problem, that globally, clinical trial awareness and participation, is to this day not commonplace, or even considered as a treatment option.

So, how can you fix this? What can we do to stop the ‘leaky bucket’ effect of patient recruitment? Well, we’ll tell you 3 patient recruitment strategies in clinical trials that can have a huge impact on your enrollment rates, but of course, there are many more strategies that can be used. Due to this, we will skip on the more traditional strategies referenced that most involved in clinical trials will be familiar with, such as ‘Focus on digital’, ‘Leverage social networks’, and ‘Collaborate with patient advocacy groups’. These all have their place, and should be core parts to any patient recruitment strategy, but if you got this far, you may want to hear something new.

In this blog, we’ll cover these 3 patient recruitment strategies in clinical trials:

1. Get patient opinions on your recruitment materials
2. Make diversity a focus, rather than a buzzword
3. Avoid site burden, aim for site success

Why should you take our advice?
At Clariness, we have randomized over 25,000 patients, across 100 indications, in over 50 countries, and in doing so, have become experts in a multitude of patient recruitment strategies that span all conditions and geographies. We know how to deliver patients, and we have the experience and data to prove it.

1. Get patient opinions on your recruitment materials

For over 19 years, we’ve produced creatives for patient recruitment campaigns in collaboration with 13/15 largest biopharma companies in the world, and more often than not, the driving opinions of the final imagery, colors, text, format, and more, come from biopharma executives, rather than patients.

While we, the sponsors, sites, and vendors, have vast experience in providing recruitment materials, and some of us are also living with the conditions we’re recruiting for, we are less informed than global populations when it comes to:

• The common terminology used to describe a condition
• Which emotions they feel when discussing their condition
• Which imagery and colors resonate most with them and their condition
• How they wish to be referred to or labelled
• The level of knowledge they have about their condition, and clinical trials
• What their trust level is with the sponsor of the clinical trial

We survey global patient populations regularly, and we ask all of the above, and align responses by indication, location, education level, age, sex, race and more, even down to their preferred sources of clinical trial information!

Therefore, when we design patient recruitment materials, we know what will perform best, because we know it’s the preferred design of those that match the patients’ characteristics of the trial population we’re marketing to.

Further, we A, B, through to Z test different verbiage, calls to action and imagery, to continuously optimize the performance of our patient recruitment campaigns. We are renowned for generating referrals on day 1 of campaign launch, but more often generate 5x the performance of the campaign within just a few weeks and months. Partner with a vendor that either gathers patient insights regularly, or can provide user testing style surveys of the campaigns you are developing ahead of EC submission to ensure you get the best performance out of your marketing and media budget. We would recommend ourselves, of course.

2. Make diversity a focus, rather than a buzzword

Clinical trial diversity has received more and more spotlight in recent years, with new legislation, new event topics, #hashtags and more, despite having been a pain point in clinical trials for decades.

We surveyed over 4,000 global patients recently, gathering insights from patients of all ages, races, nationalities, sexual orientation, income level, insurance levels and more to discover the drivers and barriers to trial enrollment for patients of all kinds. In it, we found that 70% of female participants, 73% of LGBTQ+ participants, and 96% of black participants, responded with a medium to high level of willingness to participate in a clinical trial. These groups, and many more, however, are all too underrepresented in clinical trials. If trial minorities are willing to participate, why don’t they?

Clinical trial organizers need to focus more on designing trials, and their subsequent recruitment campaigns, that resonate with underrepresented patient populations. This spans more than simply adding more inclusive and representative imagery, but also:

• Lower the literacy level of campaign and study materials
  This helps patients of all education levels better understand the trial, including its requirements and potential side effects
  
• Localize the language of your study materials and campaigns
  Translating materials into multiple languages offers patients of all backgrounds, wherever they’re located, the chance to better understand the trial and what’s required, this also helps the consideration process when materials are shared with family members of those who may not have the same language level as those being addressed
  
• Inform patients early if they will be reimbursed for participation
  This makes trials more accessible for those with lower socio-economic statuses, parents requiring childcare, or those concerned with the associated costs of participation which unfortunately is typically associated with marginalized groups

The aforementioned tactics, as part of a diversity strategy, are only scratching the surface when it comes to improving the representation of your patient populations, but they’re a good start. Partner with a patient recruitment expert, patient diversity organizations or local communities and advocacy groups to further drive your diversity plans.

3. Avoid site burden, aim for site success

Site burden is a commonly used term when discussing barriers to clinical trial patient recruitment, despite the fact sites will often recruit the large majority of total patients. The burden of sites, is of them being overworked, understaffed and in some cases, trying to find a patient population that isn’t suited to their location.

Here are some stats to shine light on the issue of site selection and performance:

• 37% of study centers fail to meet their recruitment targets
• 50% of study centers recruit 0-1 patients
• 20% of study centers have never recruited a patients

Despite this, sites are your allies. At Clariness, we’ve worked with over 7,000 sites across the globe, and today, we hold an NPS of 9 with sites. Having a great relationship, and keeping the studies we recruit for top of mind for HCPs, is what makes the difference in our average patient contribution of 25%.

The secret to this performance and our relationship, is simple: 

• Provide sites with an easy to use patient platform, like ClinLife®
• Schedule patients’ first site visits (can increase randomization rates by 3x!)
• Have dedicated team members to engage site personnel, who speak their language
• Align referrals to site capacity to ensure you don’t overload sites
• Provide a feedback loop to continuously improve site and recruitment vendor relationships

Our team, which we call the Enrollment Success Team, are what drive all of the above and more to create great relationships with participating sites, taking as much of the burden off of sites as possible, and follow-up on referrals through to randomization. They enable enrollment success by acting as a personal concierge for both patients and site staff, facilitating a smooth transition from registration to randomization.

Conclusion

There are many strategies to ensure sufficient trial enrollment, more than we can fit into a short blog and keep your attention. However, no single strategy works for all trials, they are all as unique as the patient populations they are designed to serve. To learn which strategies are best for your clinical trial, get in touch here, and we will connect you to our VP of Enrollment Strategy, who will be happy to discuss your study and requirements in more detail.