August 24th, 2016

Shifting Best Practices in Clinical Trial Recruitment


In order to reduce costs while improving enrollment outcomes, clinical trial sponsors need to start thinking outside the box.

While centralized recruitment is quickly becoming a best practice, most clinical trial sponsors continue to rely on decentralized campaigns, with each investigator site responsible for local recruitment and budgeting. The problem? Staff at these individual investigator sites don’t always have the requisite expertise, resources, or bandwidth to properly execute these objectives.

But as digital advertising and tracking platforms become increasingly accessible and intuitive, clinicians can now capitalize on many of the key advantages of centralized campaigns without fully abandoning their core recruitment practices altogether. In effect, you can think of this as a kind of “insurance policy” for your patient acquisition strategy – or, as we like to call it, “Guerrilla Recruitment.”

Make Sure You Have a Safety Net

In recent years, it’s become clear that traditional methods of recruitment are no longer adequate; today, 90% of clinical trials struggle to hit their enrollment targets on time, and 27% of U.S. trial sites fail to enroll a single qualified patient. Enrollment delays can have devastating effects on clinical trials – in fact, every additional day comes at an estimated cost of $37,000 in out-of-pocket expenses for sponsors.

At the crux of this inefficiency is the fact that there’s no way to predict which sites will be underperformers, and as a result, many sponsors end up in “rescue mode,” and are forced to hire and train patient recruitment firms or CROs and spend huge sums of money to address their enrollment problems.

By establishing a site augmentation plan at the outset of your trial, you can quickly “turn on” additional, localized recruitment support as soon as it becomes evident that a particular site is struggling. Digital media is perfectly suited to this task, as you can build out patient portal websites, social media accounts, digital ad campaigns, and submit for IRB approval well in advance of your trial, so everything is lined up and ready to go as soon as the need presents itself.

Better Patient Lead Qualification

Sending too many unqualified patient leads to an investigator site can overwhelm the site coordinator and staff to the point of frustration and indifference – such that they may fail to follow up on leads in the future. Along with an educational patient portal website, sponsors should consider utilizing online screeners and a centralized call center to avoid straining on-site resources.

Online screeners ask prospective participants simple questions – about a patient’s age, gender, whether or not they’ve been diagnosed with a specific condition, etc. – to determine whether or not they meet specific exclusion or inclusion criteria. Call centers add another, more in-depth level of vetting to the process, wherein responders can go through more nuanced screening questions and explain the basics of clinical trials to patients who may not already be familiar with the process. Together, these two processes can lower on-site screening failure rates to a relatively reasonable 30%, and reduce the workloads of investigator site personnel by as much as 81%.

It’s All About the Metrics

Of course, all of this support won’t do you much good without a solid performance tracking system to guide it. By measuring the performance of you digital media campaigns (e.g. cost per inquiry, cost per referral, cost per enrolled patient, etc.), you can continually optimize your campaigns over time to improve your outcomes.

What’s more, automated site response metrics enable you to identify underperforming trial sites the moment they begin to fall behind the curve. By tracking key performance metrics such as time to contact, follow up rates, and enrollment conversions, you can standardize your measurements for success across all sites and compare them side by side. With a solid metrics strategy and active management, sponsors can easily see recruitment costs fall by as much as 40% in comparison to more passively managed campaigns.

Put simply, while investigator sites remain an invaluable local resource for sponsors running national trials, a fully decentralized approach doesn’t offer the necessary degree of transparency, precision, and capacity to guarantee optimal enrollment outcomes. But with a Guerrilla Recruitment strategy in place from the outset, you’ll be ready to proactively address any issue that arises along the way.