What determines the success or failure of a clinical trial? Simply put: Patient recruitment and retention.

Without participants, clinical trials cannot proceed. And without sustained engagement and trial integrity, outcomes could be compromised. While both are important, the relationship between these two factors is clear: Successful retention starts with effective recruitment.

To that end, let’s explore this intrinsic link between patient recruitment and retention in clinical trials, uncovering strategies to enhance both. Understanding these dynamics can help clinical research sites, sponsors, and contract research organizations (CROs) ensure success across clinical trials.

The Recruitment-Retention Link

Clinical trial recruitment can generally be broken down into four stages:

1. Identifying suitable candidates
2. Screening patients against the inclusion and exclusion criteria
3. Obtaining informed consent
4. Officially enrolling them into the trial

From the very start, effective and centralized recruitment strategies are essential to ensure trials include a diverse panel of participants.

Further, this initial recruitment stage kicks off the screening process. Whether candidates are recruited via direct outreach through social media or a passing advertisement in their local medical facility, a robust recruitment strategy ensures they’re the right fit for the study.

How a research team executes that strategy is the key factor in whether the candidate enrolls and whether they remain in the study until completion.

The Impact of Recruitment on Retention

One survey notes that the “lack of a dedicated approach” during recruitment was the main reason for 55% of participant dropouts.

In other words, your first approach—your first impression—matters.

When conducted thoughtfully and transparently, recruitment sets the stage for a positive participant experience. Practically, this might involve:

• Establishing pre-screening processes
• Utilizing personalized outreach strategies
• Communicating the trial’s purpose, expectations, and potential benefits

Clinical trial participants who feel well-informed and valued from the outset are more likely to remain committed throughout the study.

Strategies for Effective Patient Recruitment

With an understanding of the recruitment-retention relationship, let’s delve into three ways to enhance and retain patients via a robust recruitment process.

1. Advertise Online

The digital age offers powerful tools for patient recruitment, with social media, search engines, and specialized health websites enabling highly targeted and cost-effective advertisements.

It’s essential to ensure that all advertisements adhere to FDA guidelines, as transparency and accuracy are crucial to maintaining patient trust.

2. Collaborate With Healthcare Providers

Interestingly, 64% of patients would prefer to hear about clinical studies through their primary care provider, but only 0.2% actually do. This massive gap can be bridged through direct-to-patient targeting. Removing the provider barrier from clinical research means that opportunities for participation can be directly placed in front of patients.

3. Engage With the Community

Building a strong community presence is a powerful strategy to raise awareness about your clinical trial and attract potential participants. Doing so might include speaking at live or virtual conferences or crafting informative websites where interested patients can find more information.

Tips for Enhancing Patient Retention in Clinical Trials

Your recruitment strategies engage patients early—now it’s time to keep that momentum going and shift focus towards retention.

Consider a few factors that contribute to high retention rates: 

• Communication: Beyond initial contact, it’s crucial to implement regular, empathetic, and appropriate communication strategies.
• Education: When patients understand the importance of their role and expected clinical trial conduct, they may be more likely to remain committed.
• Support: Minimizing inconveniences and smoothing out friction points throughout the trial contributes to retention.

The goal remains the same at every touchpoint: Focus on the patient. Such an approach can overcome retention challenges; a 5-year study of patient-focused clinical trials demonstrated retention rates between 95.5% and 98% among some 24,800 participants.

How can similar results be achieved? Consider a few specific aspects of patient retention.

Building Trust and Rapport

Transparent communication and genuine commitment to participants’ well-being build valuable trust—pivotal for retention. This process begins with recruitment and remains essential throughout the entire study.

Consider further building on this trust by:

• Providing opportunities for them to ask questions
• Following up with appointments or medication reminders
• Distributing newsletters or resources related to their condition

Such initiatives can serve the dual purpose of education and communication. What’s more, eligible patients who feel seen and heard are more likely to continue with the trial.

Reducing Barriers to Participation

Ultimately, study participants are volunteers free to withdraw at any time. Identifying and addressing potential reasons for discontinuing participation is thus a key factor for recruitment and retention.

These barriers often come down to three main concerns:

1. Logistical: Transportation issues, time constraints, or scheduling conflicts.
2. Financial: Costs associated with participation.
3. Emotional: Anxiety about the procedures or medicine involved.

To resolve some of these issues, a clinical researcher or trial sopnsor might implement practical measures, such as flexible scheduling options, providing transportation services, or even offering paid research.

Proactively reassuring potential recruits with sufficient information can address emotional concerns as well, easing the overall patient burden.

Leveraging Technology

Since the COVID-19 pandemic, virtual components have become integral to randomized controlled trials. Leveraging teleconference services, custom apps, and web portals can help cut down time-consuming site visits and prescreen eligibility criteria, smoothing out the recruitment and research process. One trial’s recent success highlights these efficiencies, enabling them to digitally recruit 94 participants in a matter of days.

Continuous Improvement in Recruitment Practices

Recruitment and retention efforts are an ongoing process—one that can be refined in light of new data. Determining what works (and what doesn’t) involves two key aspects:

1. Monitoring and evaluation: Collecting and analyzing key metrics can highlight areas of improvement and ensure ongoing recruitment success. Metrics might include the number of inquiries received, screening completion rates, and participant satisfaction scores.
2. Adapting to change: New protocols, technologies, and social trends continually reshape clinical trial best practices. Growing demand for more diverse trial populations and the rise of telemedicine platforms are just two examples of how you can shift recruitment and retention strategies to take advantage of these trends.

This systematic review can help refine recruitment messages to improve screening processes and overcome potential barriers that may not have been initially apparent.

AutoCruitment’s Approach to Recruitment and Retention

Patient recruitment and retention in clinical trials is no simple feat, but it’s the key to a successful study.

By leveraging this recruitment-retention link, employing patient-centric approaches, and continuously improving recruitment strategies, organizations can ensure the smooth execution and success of their trials.

Something else that can help? The right recruitment partner.

AutoCruitment employs a direct-to-patient approach to recruitment and engagement, utilizing data analytics, targeted digital advertising, and automated follow-up systems.

Our proven frameworks have achieved outstanding results for our partners. One pediatric anxiety trial boosted monthly enrollment rates by 535%, saving an equivalent of over 2 years on the enrollment timeline.

AutoCruitment is the go-to choice for finding (and retaining) the right patients for your clinical trials. Reach out today to tell us about your study and how we can help.