Clinical Trial Recruitment in the Digital Era: Some Smart Ideas

Challenging. Time-consuming. Expensive. Do words like these spring to mind when you contemplate the patient recruitment process for your clinical trials? If so, you are not alone. The challenge of recruiting patients is not only felt widely across the life sciences industry, it is reflected in some stark statistics as well. For example, the Tufts Center for the Study of Drug Development reported in 2013 that 37 percent of all sites in a given trial fail to meet their enrollment targets, and more than 10 percent never enroll a single patient.[1] This has several negative consequences. The Tufts study estimates that the original timelines for Phase 2 through Phase 4 studies usually end up doubling to meet desired enrollment levels-so drugs take longer to get to market. For each day of delay, it costs the sponsor $37,000 in operational costs and between $600,000 and $8,000,000 in lost opportunity costs.[2] A large part of the difficulty encountered in patient recruitment is rooted in the recruitment methods being used. The vast majority of trials still rely primarily on investigators to find patients as well as on traditional, old-media, mass marketing avenues-such as print, radio and television-to spread the word. But after all the effort, it is clear that the traditional tactics are not as effective as they should be. Social Media and Patient Recruitment So what is the way forward? Consider this: if you are in charge of recruiting patients for clinical trials and you aren’t harnessing the full power of social media and the web, you are seriously compromising your trial’s ultimate recruitment goals. In the digital era, 80 percent of people using the web seek healthcare information[3], with the most commonly researched topics being specific diseases or conditions; treatments or procedures; and doctors or other health professionals.[4]Digital media reach all age groups, not just younger ones; 71 percent of U.S. adults between the ages of 50 to 64 look online for health information and 58 percent of those over age 65 do so.[5] Statistics like these make it plain that there is a vast potential recruitment population that can be found online. Utilizing digital media and social platforms is quite cost-effective compared to traditional mass media; in addition, online messages can be targeted to specific groups, both demographically and geographically, and there are no regulations or case laws that restrict which media may be used to reach prospective trial subjects. Some pharma companies already have Twitter accounts, Facebook pages and followers-but it is worth assessing whether they are using such social media tools effectively when it comes to patient recruitment, giving potential trial subjects and their caregivers information they can understand and trust. Let’s review some of the ways this can be achieved. Digital Strategies for Attracting Trial Subjects To begin, it is worth performing a Google search for every medical-oriented website that your target patient population is likely to visit. Once this list has been drawn up, placing notices on these sites announcing trial recruitment is a great investment. The exact messaging is up to you, but the notices should get across the key messages about the trial and instruct potential patients where to go for more information. In tandem with this, it could be helpful to link banner or pop-up advertising to search engine results. For example, a notice about a clinical trial in fibromyalgia patients might appear next to an article on pain in the online edition of a popular women’s magazine. You also may wish to take advantage of the immediacy of the web to build a “Call Now!” feature into such a notice, via Google Voice or similar technology, so that interested people can get more information about the trial immediately. Alternatively, you may wish to create a free podcast that discusses the goals of the trial-it is a great way to build interest. The study’s lead researcher could talk alone or in an interview format with a partner. Even more elaborately, you could host and record a video conference that lives on your website, allowing the researchers to discuss the aims of the trial in detail. On a related note-remember the blogosphere! There exists a vast population of bloggers with an interest in specific medical conditions-many of who have that condition themselves and are therefore very sympathetic when it comes to upcoming clinical trials in the field. Each of these blog has its own contingent of dedicated followers who trust the blogger for information and advice. Contact these bloggers and see if they would be willing to post information about your trial. They can be very influential in raising awareness and supporting trial participation. All of which brings us to your website, which prospective trial participants are certain to visit in order to learn more about the trial…and about you. While this isn’t the place to go into an extensive set of recommendations for website design, just remember: first impressions are lasting impressions. Your website is your brochure and business card, so make it functional, neat, clean and informative. All the information about the trial should be there and should be easy to access. The website could include an interactive screening tool to let patients determine if they are eligible for participation in the trial. Next, don’t forget the power of unique content creation. It is extremely worthwhile to compose a short article-say, 400 to 500 words long-with engaging and informative information about the medical condition your trial is investigating. If you are studying arthritis, for example, the article can be in the form of a bulleted list: “Top Five Things You Didn’t Know About Arthritis.” Alternatively, the piece can begin with a hook to a recent high-profile news item involving an interesting research finding in arthritis. Then, in the very last paragraph of the piece, you can highlight your upcoming trial and tell readers how to get in touch for more information about recruitment. The article can be posted online via various wire services. Twitter, Facebook and Beyond Turning to Twitter, remember that you can create any hashtag you like or use an existing one-for example, #diabetes-and tweet it alongside a link to your trial recruitment web page. This is a sure way to reach the many active users who are searching on that specific term. And don’t forget that hashtags are acceptable in all forms of social media. By “feeding your tweets” across multiple platforms, you are creating a uniform, platform-agnostic campaign for your trial recruitment effort. If your tweets link back to a post on your Facebook page about the trial you are recruiting for, remember some basic ground rules. Be conversational: speak the language of your prospective patients (no medical jargon, please) and attempt to communicate with authenticity and personality. This will raise the engagement level of your prospective subjects considerably. Also, shorter posts aren’t important exclusively for Twitter; statistics suggest that the shorter any post is, the stronger the engagement with readers. When it comes to boosting your ability to spread the word about trial recruitment on social media, you may wish to utilize a social media management app such as Hootsuite, which makes sharing very fast and very easy. The system’s user interface takes the form of a dashboard and supports social network integrations for Twitter, Facebook and many other platforms. With Hootsuite, you can write a message, shrink a link, choose the platforms you want to deliver to and schedule a post to go out instantly or at some later time. One final piece of advice may surprise those who remember what was said earlier about traditional media. The fact is that third-party online coverage is the best social media strategy. The best response to your trial recruitment program will result from coverage on any page of the online outlets of traditional media. If FOX, CNN, NBC, CBS, ABC and other significant networks-or major newspapers, magazines or trade publications-are including news about your trial recruitment anywhere on their websites, this is about as good as it gets, because of the sheer traffic numbers these sites experience on a daily basis. The digital era is here to stay…and the future of effective patient recruitment lies online. Keep some of these insights in mind, and you will be doing the absolute best to prepare for the patient recruitment phase of your next clinical trial. Dian Griesel, Ph.D. is the founder and president of Dian Griesel International, a corporate communications firm in New York City. Over the course of her career, she has guided the public relations programs and clinical trial recruitment for more than 300 companies in the life sciences sector. [1] Impact report: 89% of trials meet enrollment, but timelines slip, half of sites under-enroll. Tufts Center for the Study of Drug Development. Vol. 15, No. 1. Jan/Feb 2013. [2] Ibid. [3] Fox S. The social life of health information, 2011. Pew Internet and American Life Project. Available at: http://www.pewinternet.org/2011/05/12/the-social-life-of-health-information-2011/ [4] Pew Research Center. Health fact sheet. Available at: http://www.pewinternet.org/fact-sheets/health-fact-sheet/ [5] Fox S. and Duggan S. Health online 2013. Pew Research Center. Available at: http://www.pewinternet.org/2013/01/15/health-online-2013/