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Increased outreach is necessary to combat poor recruitment and large focus on patients near study centers.
One of the key reasons for poor recruitment lies in the general lack of trial awareness among both patients and healthcare providers (HCPs). Throughout the history of clinical research, recruitment has largely been focused on patients living in relatively close proximity to major academic study centers—specifically, large hospitals affiliated with prominent universities.
Not only has this created a great deal of homogeneity in enrolled patient populations, but it has also served to keep most clinicians outside of these hospital networks in the dark about trial opportunities for their patients. And while enormous budgets are spent on direct-to-patient outreach, connecting with physicians can provide indirect access to dozens or hundreds of patients through already existing trusted relationships, likely leading to a lower screen failure rate based on the HCPs’ understanding of the individual and inclusion/exclusion criteria.
The influence HCPs have with their patients cannot be understated. Most patients choose a primary care doctor and remain with them for years. Patients with specific conditions likely rely on the same specialists for the duration of their care. The result is that patients trust their doctors. In fact, a 2021 Pharma Intelligence article states that 81% of patients who had never participated in a clinical trial would be likely to do so if referred by their doctor.
The clinical research industry can do more to reach out to clinicians working outside the central academic center bubbles. By connecting with and informing clinical leaders in smaller communities, rural communities, economically-disadvantaged communities, and others, sponsors can exponentially expand their reach to more—and more diverse—patients.
Following are a few strategies to help reach more HCPs and, through them, their patients...
Make It Easy for Busy Clinical Trial Site Teams—This is a key reason why there have not been strong pushes to reach out to physicians outside traditional research networks. They simply do not have the time to conduct a trial. Luckily, solutions and technologies exist that can help get recruitment materials out to more HCPs with targeted messaging without adding new tasks for the site teams. The best solutions literally run in the background, educating clinicians, and providing them with information to share with their patients while site teams continue to focus on other trial responsibilities. One example is Trial Awareness by ClinOne, which curates a proprietary network of HCPs by therapeutic specialty and geographic region, then informs them of clinical trials that may be of interest to their patients (and connects them with local enrolling sites). Using solutions like these, sites can increase and optimize recruitment activity without hurting their team’s productivity by adding labor burden.
Automate Outreach Campaigns—Today’s digital marketing technology allows for automation to keep messaging moving and keep potential patient recruits coming into the enrollment funnel. Keeping with ClinOne Trial Awareness as an example, study teams can map out their messaging and recruitment campaigns, including protocol information, inclusion/exclusion criteria, site information, and custom content. The platform reaches out on a consistent basis to HCPs to keep study opportunities top of mind as they meet with patients—and provide them with multiple options to learn more about the trial or speak directly with site contacts. Automated regular outreach with actionable links helps ensure coverage, understanding the need to reach different HCPs at different times and with different types of messaging.
Be Cost-Conscious—Digital recruitment strategies that focus on patient outreach often require multiple messaging changes, multiple touchpoints, and high frequency to try and reach the numbers of patients needed to enter the enrollment process. HCP outreach, on the other hand, can be much more efficient. Physicians, obviously, will more quickly understand what a clinical trial is trying to accomplish and how it may benefit their patients. They will, generally, require less explanation regarding study protocols and eligibility criteria than a patient would need. Because physicians have the best interests of their patients in mind, they are likely to share information about clinical trials if they think a patient will benefit. The fact that referrals from trusted physicians are much more likely to be taken seriously versus recruitment ads seen outside their doctor visit, means that a digital campaign to reach HCPs is likely to be much more cost-effective than patient-targeted campaigns. An idea is to use an eNewsletter to showcase the trial for local HCPs and include a study-specific landing page for more information.
Don’t Expect a Miracle—Engaging HCPs is not a miracle cure. Patient recruitment is a complex, nuanced and multi-faceted challenge, and no single solution will solve all issues instantaneously. It will, however, raise awareness within the local medical community which can have both a measurable direct and a qualitative indirect impact. By raising your study’s profile, you will generate increased word-of-mouth and conversations between physicians and patients. And by providing site contact information, you will encourage physicians to reach out directly to counterparts they know at nearby institutions to discuss individual patients—often leading to highly qualified peer-to-peer referrals. The success of such a program should consider a number of metrics including engagement rates, visits to your trial’s study page, and feedback from sites in addition to any uplift you experience in screenings, referrals, and enrollment.
Provide a Ride—When HCP outreach is used to expand access to patient pools that are geographically diverse and located further from the clinical site, it can be beneficial to both recruitment and retention to include ways to make participation easier for them. That’s why ClinOne provides not only virtual visits, but also partners with Uber Health for a Patient Ride solution. In fact, a 2022 Applied Clinical Trials survey found that 95% of sites believe providing transportation improves recruitment efforts. Patients and caregivers are faced with challenges that include consistent access to vehicles, the expense of driving and parking, physical or mental hardships, the anxiety of scheduling, and traffic. Providing patient rides together can unlock the full value of awareness.
Better recruitment can have a positive cascade effect on any clinical trial. Getting more eligible patients into the enrollment funnel more quickly can help studies start on time. This can help sponsors get their new drugs and therapies to market faster where they can help more patients while allowing sponsors to maximize their opportunities for market exclusivity.
Digital recruitment campaigns that focus on HCPs allow sponsors to greatly expand the number of clinicians in the loop about their studies, in turn giving them access to much larger groups of patients. The trust those patients have in their HCPs can lead to higher-quality referrals more quickly than patient-targeted digital recruitment strategies. Further, these higher-quality referrals are more likely to lead to high patient retention versus less targeted recruitment approaches, helping to keep studies on track.
Bill Meisle, Director of Digital Engagement & Optimization, ClinOne