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On World Cancer Day, Shahana Chowdhury provides advice on how to overcome the obstacles of recruiting and retaining patients for oncology trials
Patient recruitment is one of the most difficult challenges faced when running clinical trials, and is particularly acute in oncology trials. A considerably low number of 3 percent of potential patients volunteer to participate in oncology clinical trials. The difficulty in recruitment can cause overall delays to such trials. Currently less than 20 percent of studies are on-time, meaning the majority of the trials fail to meet initial plans and expectations. There are many reasons why patient recruitment remains a challenge:
Furthermore, a lack of focus on the patients throughout the trial can be a negative point to deter them from participating. The aim of a patient-centric clinical trial is to provide a convenient and pleasant journey for the patient, which lessens the burden of participation.
Evidently, patient recruitment is a huge problem within oncology trials. However, there are ways to tackle this. The phenomenon that is social media has become a powerful communication tool and is increasingly being used within the clinical trial space. Does the practice of using social media as a tool to recruit patients really work, or is it just another example of an insufficient process?
Social media channels are particularly effective in grabbing the attention of individuals and are a solution to overcome the challenges of patient recruitment. The average person checks social media 17 times a day. During this time, they are browsing on social media and may also seek information about and/or support for their disease. Using one opportunity of 17 daily check-ins to reach potential patients with clear and actionable information is very possible.
Social media is a solution that enables efficient targeting, is measurable, and provides actionable education, as well as accurate demographic and user disposition. While using it to recruit patients, social media can also act as an opportunity to promote the trial. Communication with patients is key when interacting online. For clinical trial sponsors, a patient communication strategy must vary by geography in order to reflect the cultural differences between regions.
Now that you have recruited participants it can often be a challenge to get patients to return to the study through follow up. Patients usually fall very sick and are unable to travel to the study site resulting in the trial not reaching its endpoint and incomplete data.
Home nursing is the predominant solution to tackle this obstacle. Home nursing can reduce the risk of patient dropouts by bringing the study to the patient’s home, which removes the requirement of travelling to a trial site. Protocol-specific training, customized visit materials, and a severe quality control process that meets all study requirements is however necessary to conduct successful in-home visits.
Good communication with patients can also tackle this problem. Text messaging is now a widely used tool to communicate with patients. Incorporating this into the trial process to notify and gain updates on patients’ conditions can increase retention rates.
Although patient recruitment and retention can be seen as problematic, particularly in the oncology trial field, there are solutions. With the rise of social media, it is a tool that can be integrated to both recruit and retain patients. While a home nursing situation for patients can be complex logistically to organize, if incorporated into a study, the retention rate of patients can increase.
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References:
1. Improving Standards of Patient Recruitment and Retention in Clinical Trials, https://www.oneresearch.co.uk/2014/10/12/improving-standards-of-patient-recruitment-and-retention-in-clinical-trials/
2. How to Maximize Patient Recruitment in Oncology Trials, https://www.covance.com/content/dam/covance/assetLibrary/articles/Covance_playbook_march_2017_final_web.pdf
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