How to speed up your clinical trial recruitment

According to a recent study by Tufts Centre for the Study of Drug Development, around 80% of clinical trials experience significant delays due to hurdles during the patient recruitment phase. The recruitment of trial patients is generally a costly and time-consuming process that can set companies back before they have even begun testing a product or treatment. Knowing how to reliably recruit and retain participants is essential to the delivery of any successful trial. In this article, we will outline common challenges in the recruitment process and provide you with helpful solutions to overcome these obstacles.

The clinical trial recruitment process

The recruitment process for clinical trials typically goes through multiple stages, they are:

1. Identifying potentially eligible participants

2. Referring participants through sales, self-referral or other

3. Conducting screening, e.g. physical examination

4. Confirming eligibility of potential participants

5. Acquiring consent from participants

6. Gaining informed consent

7. Enrolling participants based on the eligibility

8. Continuing study with selected participants

Key clinical trial recruitment challenges

Clinical trial recruitment and retention

What does Lasagna have to do with clinical trial retention?

In the 1970s, the US physician Louis Lasagna observed a peculiar phenomenon in clinical trial recruitment and retention. The number of eligible trial patients appears to drop by 90% on the first day a trial commences, followed by the number of potential participants returning to pre-study levels once the trial has completed. This is known as ‘Lasagna’s Law’ and is commonly observed throughout many clinical trials.

Nearly all researchers experience barriers to attract participants for clinical trials. This seems to be a historical concern that continues to disrupt clinical trial development, with 19% of trials closing early because they could not reach their target number of participants.

There are many reasons why trials struggle with retention with a 15% to 40% drop out rate before a trial has even started. One reason is the imbalance in patient suitability and their interest, another is the challenge to correctly estimate how many participants you can recruit from your desired patient population.

Studies show that as many as 86% of trials fail to meet their recruitment quotas on time and 76% of discontinued clinical trials are terminated due to poor recruitment processes. Having a strong participant attraction and retention process can minimise these risks, saving you from unexpected delays and rising costs.

Clinical trial recruitment cost

Costs of clinical trials are heavily impacted by the possible recruitment pool, advertising activity, technology used and regulatory costs. Most clinical trials represent a substantial financial commitment for any pharmaceutical company — from the initial stages all the way through to when a drug goes to market.

The average recruitment cost per trial patient is more than $6,500 (£5,100). It takes an average of $19,000 (£14,800) to replace a patient who has dropped out. Speeding up the recruitment process in clinical trials can effectively help to minimise the negative impact of poorly matched patients and the higher costs associated with pharmaceutical research.

Clinical trial recruitment and diversity

One area where AI may fall short in clinical trial recruitment is in the inclusion of certain potential patient groups. It is a common issue where potential patients with impaired and ethnic minority backgrounds are underrepresented.

Over the last year, investigations began that saw a growing number of ethnic minorities being neglected across clinical trials for the COVID 19 vaccines. Additionally, a 2022 Harvard study discovered that women were also underrepresented in key disease clinical trials.

The main problem that AI faces when it comes to using historical data when finding potential patient pools is that it won’t be able to find these underrepresented groups because of a lack of data.

Four effective strategies for faster clinical trial recruitment

1. Employ digital marketing strategies

Using digital marketing strategies could be the key to recruiting more patients for your clinical trial. Some participant attraction activity can be done for free and requires knowledge of search engine optimisation and organic social media marketing.

You will be able to target advertisements to specific audiences, e.g. by demographics, location and interests on social media platform like Facebook, Instagram, and TikTok as well as on search engines like Google and Bing. Having a budget for paid advertisement will likely help you to reach your desired participant pool more easily.

Another point to keep in mind is at this stage, using patient-friendly language is crucial to attracting the right candidates to help to fill any gaps for your recruitment pools. Not only are digital marketing tools free to use but they’re effective for finding the right patients from a larger participant population.

2. Use clinical trial patient recruitment companies

Another way to speed up your clinical trial recruitment process is by outsourcing your enrolment to a clinical trial patient hiring agency. These companies will have the know-how and the experience of different practices that will attract the most suitable candidates to your study. They will also have a streamlined screening process to help speed up hiring. While working with a recruitment company will incur an additional expense, they will speed up your clinical trial recruitment and help your research run more smoothly.

3. Consider patient applicants for multiple trials

Consider vetting your potential participants for multiple trials at a time. Pre-screeners can identify and target patient responses to help direct them towards other questions relating to different trials that are due to take place. This can help researchers maximise their recruitment resources since not every candidate is suitable for every trial.

4. Screen patient candidates thoroughly

Before any clinical trial can begin, pharmaceutical companies need to conduct robust and in-depth pre-screening and vetting of their patients. A pool of candidates that has been pre-screened allows pharmaceutical companies to move faster during the trial recruitment phase. Key to a successful pre-screening process are:

- A well-written script

- Questions that have been reviewed by the Institutional Review Board (IRB)

- Questions that emotionally connect to the patient

- Disclosure of all applicable information to minimise dropout rates

- A timeline and expectations that are clear to the participants

- Acknowledgement of possible reservations the patient may have

Leveraging AI and other technologies

Increasingly, AI is used to analyse large amounts of pre-screened data from potential participants. By considering patients for multiple trials, pharmaceutical companies can speed up the recruitment process, avoid delays, and maximise data at a relatively low cost. You should task someone who is experienced in the use of AI to process large amounts of data reliably. Depending on your timescales, consider investing in upskilling existing staff or recruiting trial staff who can offer this expertise.

Looking to staff your clinical trial?

While participants are at the core of any clinical trial, no study or research can get off the ground without a competent and experienced team of clinical trial staff. At Hobson Prior, we match industry-leading pharmaceutical companies with top candidates across the globe.

If you’re ready to hire, contact our experienced consultants to discuss tailored staffing solutions for your research or trial.