If you need to recruit patients for a clinical trial in a speedy manner – for example, if your trial is ‘in rescue’ or you have a limited recruitment window – here’s an overview of the 3 most effective strategies and techniques you should consider.
1) Quickest and Most Effective – Direct to Patient Digital Ads
Having been described as ‘the godfather of social media patient recruitment’, it’s probably no surprise that I suggest digital ads are the most effective method for speedy recruitment. But my recommendation is not simply because I have a lot of experience with digital marketing – it’s the fact that digital marketing consistently works extremely well. (My fundamental aim is to get patients on trials effectively and efficiently, so if I ever come across something else that works better, I’ll be recommending that instead.)
Search Ads
Digital ads are most effective when they appeal to a desire that people already have. One way that digital ads can capitalize on this is to use search ads (eg Google Ads) which will be shown to someone who searches for relevant keywords. Now, the number of people searching to try and find a clinical trial they could participate in is quite low (though increasing), so you’ll not want to limit yourself only to search phrases that include the words ‘clinical trial’ or ‘clinical study’.
And it’s likely that many of the people using search words for specific conditions are going to be either living with the condition, a carer, or a Health Care Professional (HCP). Which means that showing your ads to those people could encourage them to click through to learn more about the clinical trial you’re running, as it may be relevant to their circumstances.
Online Application
As to what happens to the person once they click through from the ad, I’m still surprised by the number of clinical trials that launch without their own website. Or, if they do have a website, there is no method of applying for the trial directly from it. (Many sponsors and CROs relying on the possibility of potential participants contacting a study site directly or navigating their way through the ClinicalTrials.gov website in order to apply). This is a big mistake.
Enabling people to apply for a clinical trial online is one of the easiest ways to capitalize on the interest the person has already shown – by clicking on the ad – and take them through to the next stage of the qualification process.
Quite simply – if you’re not providing potential trial participants with a means to apply direct from their computer of smartphone, you’re significantly limiting your chances of recruiting sufficient patients for your trial.
Social Media Ads
Whatever you might think about social media, it’s somewhere that people spend a lot of their time. (GlobalWebIndex reporting that in July 2022 there were over 4.6 billion active users of social media worldwide, with an average daily use per person of 2.5 hours).
Facebook is still the most widely used platform, and in my experience represents 60%+ of the patients recruited through digital ads. One of the great aspects of Facebook that has made it so successful is the ability to share ads with other people. Which means that, for example, if I am not living with a particular condition myself, but I know someone who is, I can share the ad with them – thus increasing the reach of the ad and having it be seen by a wider audience.
One feature of social media ads targeting – that is common to all platforms, not just Facebook – is the ability to show your ads to people based on their location and demographic information (such as age and sex). This enables you to only show your ads to people who fit within the I/E criteria for your trial protocol, as well as aiming for people who live within a certain distance from your selected study sites.
Tip: When setting up search ads, Google isn’t the only game in town. People who use Bing are likely using it because they prefer it to Google, or they’re simply using it as it’s the default search engine included with Windows. Either way, you can potentially reach an audience on Bing that you wouldn’t be able to reach on Google.
Tip: While Facebook is still the biggest single platform for recruiting patients, there are several other platforms that are worth investigating – including, perhaps unexpectedly, TikTok. (Which I have seen perform well even when targeting a much older demographic than the teenage or Gen Z population you might expect to be using it).
Tip: To speed up the process even further, you can set up a relevant ad campaign that is not trial specific – thus circumventing the need for IRB/EC approval prior to the ads going live and enabling you to generate interest sooner. People who respond to these initial ads can then be put into the IRB/EC approved process for enrolling them in the study.
2) Social Listening to Identify (and Reach Out to) Influencers and Key Opinion Leaders
One thing we all know about the internet is that it attracts a lot of people who want to voice their opinions. Mention of Twitter often conjures up images of people ranting about their own pet subjects, or heated online arguments where nobody listens to a different point of view. However, on many online platforms (including Twitter), you can also find people who are talking rationally and providing useful information to a receptive audience.
The act of ‘social listening’ is about finding the people who are talking about relevant topics on social media platforms and online forums – in our case, conditions or therapy areas. Then identifying those who have sufficient influence to be able to promote our trial in order to recruit patients for it. (ie those who have a group of followers who engage with and listen to them).
These Key Opinion Leaders (KOLs) may be doctors or medical professionals, or they may be patients or carers who have built up a reputation for providing useful information about a specific condition. Reaching out to them to have them promote your trial gives you access to an audience of relevant patients who are likely to accept the KOL’s recommendation more readily than if they are approached by someone they don’t already have a relationship with.
Tip: Having someone from your clinical team reach out to the KOL – maybe Chief Medical Officer or similar – will be more likely to generate interest from them for initiating a dialog.
Tip: Don’t just look at the main social media and online platforms. A site like Quora – where people ask and answer questions – can help identify people with a relevant following.
Tip: Social listening is also very useful for identifying the language that relevant patients are using to describe their experiences. Emulating this language in your messaging can help it to resonate with the people you want to attract into your trial.
3) Patient Databases
In theory, databases of patients living with a particular condition should be a valuable source of potential trialists. In reality, the various Patient Advocacy Groups that exist guard their data closely and are not always willing to share access to it. (Plus, obviously, there are privacy and data protection issues they will need to consider).
If you’re developing a treatment for a rare disease, you may find the relevant Patient Groups are more amenable to your approach. Whether your treatment is for a rare disease or a more common condition, though, you should be prepared to explain to the Group the benefits of their contacts taking part in your trial. And ultimately there is likely to be a fee involved for gaining access to their database. Whether that is a one-off fee for them to send out a mailshot or advertise your trial on their website, or a pay per patient fee based on their helping you reach patients who go through to randomization.
Patient Groups often receive many requests from sponsors, CROs, and patient recruitment firms for promoting trials to their database. You should ensure you stand out from the other requests by being clear about the specifics of the trial and why patients should consider participating. You should also always be transparent and timely in your interactions and signal your willingness to build a long-term relationship with the Group. (If you only appear interested in patients in order to further your own short-term ends you are unlikely to gain much traction from this kind of outreach).
Tip: Local organisations may have access to patients that national ones don’t. If you have a study site in a particular city, it may be worth searching for a smaller charity or patient group that is based in that area, as these organisations may be more willing to help promote your trial.
Tip: Engaging with individual patient advocates who are active within specific Patient Groups can help smooth the path for being able to promote your trial to the Group’s database of contacts.
Tip: As with the KOL strategy, it may come across as more credible and be more likely to initiate a dialog if your CMO or someone else from your clinical team reaches out to the Patient Group.
Conclusion
For speedy enrollment of patients into your trial, at the very least you should ensure you have a means for people to apply directly online. Combining this with digital ads is the quickest and most effective method of reaching a group of relevant people. Adding in social listening and/or outreach through patient databases gives you a proven set of actions you can take to recruit patients quickly.
And it’s always worth remembering that the quicker you recruit patients into your trial, the sooner you may be able to bring your treatment to market. Thus saving expenditure, increasing overall revenues, and – most importantly – helping more patients.