The Missing Link in Clinical Trial Recruitment

G.T. LaBorde

More than 90% of patients believe it's important for their doctor to be aware of local clinical studies,¹ as reported in the most recent CISCRP Perceptions & Insight Study. Why, then, do only 10% of physicians regularly discuss clinical research studies with their patients² and fewer than 1% of patients are actually referred to a trial by their physician?³ There is a clear gap between timely provider awareness and the availability of local trials, and a recent survey of doctors confirms it.

Doctors who participated in the survey reported that they lack access to trial information (54%), do not know where to refer patients (48%), or do not have the time to learn about active trials (33%).⁴ These factors, in turn, result in a major lost opportunity for patients to gain exposure to trials as a therapeutic option when considering their treatment options.

More needs to be done to both raise provider awareness and leverage the physician-patient relationship. The trust a patient places in their provider’s advice and the patient’s desire to explore all appropriate treatment options could prove to be the missing link in trial recruitment. In fact, research has found that only a third of trial sites in the US meet their accrual targets and around half are forced to extend their enrollment periods.⁵

The rise of digital advertising has caused many industries, including healthcare, to rely far less on traditional media outlets like television, radio, print and billboards, and instead shift marketing strategies and spend to online platforms. A key advantage to this is the ability to capture online behaviors and personal data, allowing marketers to get their recruitment messages in front of more targeted audiences based on their interests, demographics and locations. Digital media is also able to facilitate—unlike mass media outlets—immediate engagement and real-time expressions of interest.

But even with all of its advantages, digital media is only able to reach likely participants “out in the wild,'' beyond the walls of the health care facilities in which patients actually receive their care. It also broadly matches a prospective trial volunteer to a study based on imprecise data such as the prospect’s use of search terms, social media engagement, and other general indicators. What’s lacking is more precise targeting and laser-focused messaging that facilitates trial referrals at the point where doctors and patients meet, in person or virtually, to discuss the best treatment options.

In order to make that possible, trial personnel would need to leverage data mining capabilities similar to that of outside digital media, but do so with greater accuracy and relevance by accessing a patient's medical history and other health-related variables. They would also need to have the ability to notify the patient’s provider of the availability of a trial that matches their patient’s unique treatment needs, and do it all within the walls of their own health care facilities.

One such option is a technology from IllumiCare, which surfaces matched trials within the EMR workflow as a doctor is seeing a patient. It works by nudging a doctor—via a specialized app that unobstructedly hovers over the EMR—when a patient meets the criteria for a local trial. The doctor can then either discuss the trial with the patient on the spot, or, with one-click, refer the patient to a clinical trial coordinator to help them decide whether they’d like to enroll. To ensure the broadest application of the technology, the service works with all major electronic health record platforms.

Time is also an important factor to consider in trial recruitment. Reducing recruitment time lowers costs and minimizes administrative burden for trial recruitment staffers. By reducing the number of steps between a patient first learning about a local trial that matches their clinical needs and discussing it with their provider, both the patient and the trial staff benefit.

For each trial, coordinators have control over the referral criteria and which provider specialties receive point of care notifications, without EMR programming. They see all of the patients within the health system that match criteria, not just those referred by providers. They can also track key information and activities as patients move through the enrollment process. Reports and the ability to prioritize studies give insight and control to coordinators amid a typically complex process.

A referring provider can track key information and activities through the app as their patient moves through the enrollment process, and patients are more likely to share their trial experience with their provider on subsequent visits, thereby increasing compliance and improving the odds of completing the trial.

It’s been reported that $1.2B is spent annually in the US on patient recruitment.⁶ Given that fact, it makes sense that clinical trial personnel would be looking for new ways to tap into the power of the physician-patient relationship that not only significantly reduces the cost of recruitment, but also shortens the process, resulting in a higher quality trial subject in terms of matching criteria and long-term retention.

G.T. LaBorde, Chief Executive Officer at IllumiCare

References

1. CISCRP Perceptions & Insight Study 2021, pg. 5
2. CISCRP Perceptions & Insight Study 2021, pg. 27
3. Tufts Center for the Study of Drug Development, Impact Report, Jan/Feb, 2017, Vol. 19 No. 1.
4. Tufts Center for the Study of Drug Development, Impact Report, Jan/Feb, 2017, Vol. 19 No. 1.
5. Treweek S, Lockhart P, Pitkethly M, et al. Methods to improve recruitment to randomized controlled trials: Cochrane systematic review and meta-analysis. BMJ Open. 2013
6. Ray K, Tosti B. Transforming Patient Recruitment through Patient and Site Engagement. 2017