I recently outlined some strategies you should consider for speedy recruitment of patients into clinical trials (https://www.rossjackson.co.uk/3-strategies-for-speedy-enrollment-of-patients-into-clinical-trials/) and now I’m highlighting some approaches you can take for recruiting patients over a longer time frame.
Why Recruit Patients over a Long Period?
At its simplest, you may have, for example, a 2-year period from the launch of your recruitment campaign to the time of ‘last patient in’ – giving you a reasonably long time frame to implement your enrollment strategies.
Another consideration may be if you anticipate conducting multiple trials for the same condition or therapy area over a long period. For instance, if you specialize in a particular type of treatment. Your recruitment activities here may be based on identifying people who wish to participate, then getting in touch with them when a suitable trial is available.
Database of Potential Participants
Building up your own database of potential trial participants is an approach that can be very successful in the long-term. This is particularly useful if you know you will be working in the same therapy area for the foreseeable future, with multiple trials in your predicted pipeline. While you may not currently have anything available, you can attract applications from people who are expressing their interest. Thus you have a readymade database of potential patients who you can assess for the future trial’s criteria.
Database building can also be effective for enrolling participants in trials when they may not be suitable for an initial one they apply for. This can be especially valuable for organisations that specialize in developing multiple treatments for a particular condition – as people who didn’t fit the Inclusion/Exclusion criteria for one trial may qualify for a future study.
Digital Ads for Long-term Patient Recruitment
With my background in digital marketing, this may make some people think ‘to a man with a hammer, everything looks like a nail’. But I make no apologies for continuing to promote the use of digital advertising when it comes to patient recruitment, as I’ve yet to come across any other method that delivers large numbers of patients for trials as successfully.
Certainly, other methods also work, but for the biggest ‘bang per buck’, digital ads remain the number one most effective means of attracting trial participants. Both in the short and the long term.
The digital ads platforms all have their own regulations that you’ll have to conform to – with Facebook in particular being very strict with the type of content it allows to feature, and platforms such as Twitter not allowing clinical trials advertising throughout most of the world.
Tip: Ads that are not based on a specific trial need not pass IRB/EC approval – enabling you to build up your database of potential participants over a longer period and ongoing. For instance, your ad can suggest that you’re looking for people to indicate their interest in taking part once a trial becomes available. Then you can follow-up with them once you have a suitable trial and IRB approval for your patient-facing communications.
Tip: Once you have a sufficiently large database of potential trial participants, in platforms such as Facebook you can use this to build Lookalike audiences – ie Facebook will use the Lookalike audience settings to show your ads to people whose online behaviour is similar to that of the people in your database. The idea being this will help you to target people who are more likely to want to participate in your trial.
Tip: Facebook and other platforms consistently steer advertisers towards video ads as being the most effective method of communicating a message. However, in my experience it’s still ads based on having a single image that attracts the most interest – the type you’ll be familiar with from the standard Facebook feed.
Informational Website
One of the best long-term methods for building interest in a trial is to develop and promote an informational website featuring content about the condition and the trial itself. I’m still surprised by how many trials launch without their own website – effectively cutting off a large proportion of people who might be encouraged to apply to take part.
Including a method of applying for a trial, or registering interest in possible future trials, is a very effective means of you building your own database of potential trial participants. Incorporating pre-screening questions in the application form – linked to a suitable backend patient platform – will enable you to identify people who are suitable for specific trials, based on the relevant I/E criteria.
As well as details for specific trials, of course, you can simply develop an informational website that is condition-specific and talks about trial participation in general. This can help to build interest for when you launch a trial in the future, plus give you more credibility among the patient population through providing useful information.
Tip: Informational websites can be useful from an SEO perspective (Search Engine Optimization). Providing useful data and information that may not be available elsewhere – for example, any relevant trial data you may have collected in similar trials – can help your website rank higher in search engines for relevant searches.
Tip: Creating content based on the testimony of existing/previous trial participants can prove very effective for building a rapport with the patient population. Obviously, you have to be mindful of regulatory issues regarding anonymity, but you may be able to create content based on a previous trial that can help inform potential participants of what to expect.
Community Engagement
Having an ongoing dialogue with people who could participate is an underused technique for generating interest in your trials. Through means of communication, you can build trust in the idea of joining a trial, as well as helping cement the concept in people’s minds as being one they should consider.
Patient communities are an obvious place to look at here – with each condition likely having multiple groups where patients and caregivers can share information. Be aware, though, that patient groups can be distrusting of organizations who appear only to be interested in them when they want something from them – ie when looking to recruit trial participants. In particular, it’s usually proven particularly difficult to gain any traction with the many patient-related Facebook Groups that exist, as these are generally closely-guarded environments designed for people to discuss their condition with like-minded others.
You should also bear in mind that patient groups (including such organizations as Patient Advocacy Groups) are only representative of those people who have actually joined the group. There will be other potential trial participants who are not interested in being part of a group, so you shouldn’t assume you are reaching the entire possible audience if you do start communicating with a patient group.
Outside of patient groups, of course, there is the opportunity to build interest within other types of community – such as people in a particular location. This can be especially effective if you know you are likely to have a participating site in the locale, and wish to generate some interest prior to the launch of the trial.
Diversity and Inclusion have very much become more prominent in people’s thinking when it comes to attracting patients for trial, so developing a relationship with a particular community in an ongoing manner – ie not just when you’re recruiting for a specific trial – can be a great way to build trust and have your message resonate more effectively.
Tip: Patient-based information, such as that developed for the Informational Website suggested above, can be used for approaching patient groups and encouraging them to share it with their members. For example, video testimony regarding trial participation, or an outline of someone’s experience living with a particular condition.
Tip: Local communities often have focal points that can be utilized for presenting your message and becoming more widely-known. For example, churches, community centres, local markets, shopping malls, charity events etc.
Press and Traditional Media
When I was first involved with patient recruitment, the standard advertising methods for central recruitment campaigns were radio and newspaper ads. Indeed, these approaches are still widely-used today – though have been somewhat superseded by ads on digital platforms such as Facebook and Google.
Traditional promotional methods still have their place, though – especially when it comes to supporting other activities for building awareness of a trial in the long-term. (The idea being that if someone sees the trial featured in a newspaper, then hears about it on the radio, then sees it again on social media, the message will sink in more strongly).
As well as the obvious advertising opportunities, it’s also worth investigating how to make use of PR to generate interest in your trials. Editorial articles within a magazine or newspaper can help to raise awareness that a trial exists. Similarly, an appearance on radio or TV shows (or podcasts) as an expert guest can help build credibility.
Tip: Try to identify something newsworthy about your trial that you can incorporate in your PR efforts. For example, a local celebrity, or someone with influence in a particular community, may be interested in helping promote your trial.
Tip: If you are able to identify a high prevalence for the condition in a particular demographic, you may be able to target them through a publication or broadcast show aimed at those people. (e.g. local newspaper, special interest magazine or podcast).
Conclusion
Recruiting patients for clinical trials in the long-term is not just beneficial for the trial in question, it helps promote the idea of trial participation in general.
This kind of snowball effect of having more people interested in taking part in trials can only be a good thing for the industry as a whole, and for helping with enrolment into your future trials.