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Clinical trials under threat due to poor patient recruitment

Written by Andrew Mills, Business Development Director, CHASE clinical. 

There are several key challenges with modern clinical studies. Too often feasibility and patient recruitment are neither given the focus nor resources they deserve. This means trials underperform due to poor recruitment and site selection or lack of momentum to enrol patients. Delays mean medicines taking longer to reach patients with associated increase in costs.

Anyone involved in the clinical trial process is aware this situation occurs but what can we do about it? Throwing money at the problem does not necessarily provide an answer, though several solutions exist such as rescue recruitment. Companies offer this resource, though few in reality are able to secure immediate resource to address the issue. 

When patient recruitment is behind plan, sometimes it is about getting the basics right. Motivated, well supported clinical research nurses and study facilitators recruit more effectively. There are also softer skills required to create a true partnership with principal investigators and patients alike. This means education and support are vital throughout the recruitment process, not just the start and finish.

What are the key challenges in patient recruitment and retention? A lack of patient awareness can be addressed by using social media, text messaging, website search engine optimisation or search engine advertising to bridge the gap more effectively. Engaging with patient representative groups can improve recruitment, though this approach brings its own challenges.

Artificial Intelligence or technology have a role and thought leaders have suggested new ways technology can recruit and retain patients in clinical studies. Patient-friendly data collection will help both recruitment and retention. Systems which interact with a smartphone can support patients to collect and record improved data sets in a more timely way.  One aim is to fit the data collection within the patients’ lifestyle rather than being seen as an inconvenience. Wearable devices have the potential to collect data automatically and more reliably. Many companies are offering new ways of collecting data throughout the trial.

NICE has published new standards and identified ways of classifying or categorising digital health products against any potential risks they may have in their use with patients or functionality. The level of risk ranges from lifestyle information to diagnostic data which can be used by clinicians. Many providers now supply wearables and validation of the technology remains critical. 

Educating the patient population about their health condition can result in improved recruitment and retention in studies. This is especially beneficial in long term conditions which need to be managed over a lifetime after the trial has ended, such as diabetes or multiple sclerosis.  Patient support groups have a role in recruitment and retention. 

In summary, patient recruitment is a highly complex area and poses real challenges. Should more technology be used? Or better patient targeting prior to the study and feasibility? Are we getting the basics right? Or is there something else? CHASE clinical can offer a solution to these common challenges including a patient focused approach and reaching out to patients via domiciliary visits. What do you think? I look forward to your thoughts.

Andrew Mills is Business Development Director at CHASE clinical. If you’re interested in finding out more about CHASE clinical, or wish to discuss your patient recruitment options, please call 0131 553 6644 or email