How Funding Cuts Are Undermining Patient Recruitment in Clinical Trials

In a recent video interview with Applied Clinical Trials, Kyle McAllister, co-founder, CEO, Trially, discussed the impact of funding cuts on underrepresented populations in medical research, emphasizing the importance of diversity-focused research. He highlighted the challenges created by budget cuts, particularly in patient recruitment and retention, due to reduced support staff. McAllister noted that artificial intelligence (AI) and new technologies like telemedicine are crucial for addressing these challenges by automating tasks and improving efficiency. He provided examples of AI's success in reducing chart review time and increasing patient enrollment in studies.

ACT: What specific challenges are funding cuts creating for patient recruitment and retention?

McAllister: At Trailly, we work very closely with the folks like frontline research staff, the folks that are actually on the ground doing the research, so research coordinators, research assistants, the people who really keep these trials running and humming. Unfortunately, those positions end up being the first to go basically, in a lot of these budget cuts, and it's not any fault of the sites or institutions necessarily that have to make those cuts. They're very difficult decisions, but cutting that support staff type role has a really big impact. I think it's a little bit short sighted, and it ends up cutting the people that are actually on the ground making this research possible. That impacts both NIH funded and industry sponsored research, because the research coordinators and research assistants that do this work are already stretched thin. Imagine you're a full-time job recruiting for and managing five really complex protocols. Your colleague that also had five protocols gets let go. Now you have 10 protocols that have to get managed by a single individual. They're going to focus on the direct, immediate patient care right in front of them, the people that are walking through the doors for research. Unfortunately, the things that get stretched thin or become almost like a side hustle to a lot of these folks, is recruitment, it's retention, it's calling patients before and after visits. It's the things that make patients feel really comfortable coming in to do research that have to become kind of like a background job, and it switches everything from being proactive to reactive that pushes things behind.

The other thing that may be more troubling about it is the types of research that are government funded typically are rare diseases, pediatric conditions, other conditions that are not necessarily profitable to focus on that aren't industry sponsored, and the people that are leaving or being let go are the folks that do that work, they're embedded in these vulnerable communities, and the trust they've built over years of actually working in that population, and in that group goes with them, the work they're doing with patient advocacy groups, things like that. I think we are at risk of losing a lot of that with some of the staff that's being let go with these budget cuts. I think that's a vicious cycle, too. Ultimately, that impacts the enrollment on these studies. Ultimately, this really important research is going to have study delays, probably study terminations, so we're just not going to have breakthrough research in some of the spaces that we otherwise would have had breakthrough research. The irony of it is it cuts budget now, there's immediate savings now, but what's the long-term impact? What's the cost that we face in healthcare costs, study costs, etc. that come from this?