Special for Delegates of Patient Recruitment and Retention Summit and our readers, UBC Team shared their key company’s insights.
In this interview, UBC team will illuminate such questions as: what strategy should be implemented, how to keep stuff motivated, what is the future of Patient recruitment and many more.
By Shazia Ahmad, Director; Nancy Mulligan, Director of Operations; Heidi Ross, Project Director
United BioSource (UBC) provides comprehensive clinical, safety, and commercialization services to help make medical products safer and more accessible.
UBC brings together renowned scientific research and operations experts with leading-edge technologies, allowing for the best patient and healthcare provider experience. Comprehensive, end-to-end services cover product and patient population characterization during development and market entry, as well as a focus on the patient experience, safety, and adherence.
- What are the most compelling challenges organizations are facing in patient recruitment and retention?
- Shazia Ahmad: More than ever, pharma companies are under pressure to get market approval on drugs under aggressive timelines. However, taking the time to integrate critical strategies can actually yield successful patient recruitment and retention more quickly. We need to improve the clinical trial process for participating sites and work more closely with patients on trial design and messaging so that we ensure that we are using the right strategies to enroll the right patients. Doing this early on will significantly improve patient recruitment and retention.
- Can you share some patient enrollment tips?
- Shazia Ahmad: Enrolling the right patients takes experience, research, appropriate sites, and the budget and ability to bring in patients from a variety of different sources. Integrating considerations around cultural or ethnic backgrounds is important in every study and becomes particularly important as you develop global recruitment strategies. For every study, you must consider the lifestyle, time availability, and knowledge of clinical trials for each target group. Where do they get their health information? Is their doctor key to enrollment in a trial? Will they be able to meet the requirements for multiple visits within the needed timeframe?
- How do you decide which strategies to implement?
- Shazia Ahmad: First you have to understand your target audience. This goes beyond the typical demographic factors such as age, ethnicity and geographic location. Critical components to the patient profile include information on whether that patient population utilizes online resources, whether caregiver or lifestyle factors need to be considered, and what factor is motivating that patient to participate in research. With a deeper understanding of the patient’s profile you will be able to develop a focused approach using the right messages and activities.
- What’s a new strategy your organization is using to recruit patients in today’s world?
- Heidi Ross: Increasingly, patients are looking to participate in a clinical trial that allows for flexibility around the demands of work, school and other commitments. Our organization has found that by offering home health clinical trial nursing services we can alleviate the burden to the participant without jeopardizing the integrity of the study. In essence, we are bringing the study to the patient’s home.
Our home health clinical trial nurses can perform abundant services such as education and training, administering investigator product (IP), drawing labs, collecting vital signs, performing assessments, collecting patient diaries and patient reported outcomes (PROs), just to name a few. They can even act as a courier by picking up study medication at the study site and transporting it to the home. Use of home health clinical trial nurses can allow for faster enrollment, greater compliance, and increased retention
We also employ a concierge program which provides travel services, including lodging, airfare and transportation services around study visits for our U.S. and global study programs.
- How do you keep site staff motivated?
- Heidi Ross: The demands placed on study coordinators (SCs) are daunting and include maintaining pre-screening and screening logs, completion of case report forms, regulatory documents, and training memos, study-level training as well as site specific training, preparing for monitoring visits, responding to emails and voice messages and the ongoing demands of working with the principal investigator (PI). Most SCs are spreading their time across several studies at any given period, with each one competing for time and attention.
To alleviate the daily stress and challenges faced by the site staff it is important to motivate, recognize, and reward staff for their hard work and dedication. Reward accomplishments with something as simple as a thank you card. Reinforce the importance of their work in clinical trials and recognize the contribution they are making to the lives of many.
Not all site motivation programs require a large budget. While occasional staff lunches or gift cards are wonderful, site PIs and managers need to get more creative with what they do for staff. Is there a VIP parking spot that can be offered to a hard working staffer who just completed enrollment early? Also consider allowing flexibility around daycare, school, etc., by creating additional shifts (i.e. 3pm to 6 pm, 1 to 5 pm, 8 am to 12 noon, etc.). Create an “Adopt the Family” program around the holidays to engage staff in a worthy cause.
- Does your company use e-recruitment?
- Nancy Mulligan: We use e-recruitment for nearly all of our patient enrollment campaigns to some degree. The number of people over 65 years of age who are online is growing exponentially and accessing digital information is essential to people around the globe. While digital recruitment provides a world of opportunities, it also creates a more competitive recruitment landscape as well as what can be overwhelming choices in patient communications.
We help our clients maintain focused and effective e-recruitment strategies. We research each potential patient group so we can ensure that we are identifying the best vehicles for reaching them. We also choose a combination of search engines, social networking sites, and specific medical or advocacy sites that will reach each audience in a cost effective way. Online outreach is also helpful in enhancing the effectiveness of other enrollment tactics, such as traditional advertising, direct mail, or community outreach.
- What is your opinion on the future of patient recruitment and retention?
- Nancy Mulligan: I believe that patient recruitment has gotten more and more challenging. Many people don’t fully understand clinical research, aren’t aware of clinical studies that may be of interest to them, and already have too much that is competing for their attention. TV advertising is not as effective for many studies, probably because most people do not watch TV in the same way they did even 10 years ago. With Netflix and Amazon, for instance, we can avoid watching TV commercials altogether. Many people in urban areas work flexible schedules or work from home, thus decreasing the effectiveness of drive-time radio, and direct mail is often a no go when you are dealing in pediatrics or sensitive medical conditions.
The future will require more effort on several fronts. First, learning more from patients before the protocol is developed will help us determine how they feel about their medical condition and what we might do to appeal to others like them. We need to layer our strategies because clearly the days of one successful tactic are gone. We need to do more community outreach and work more with advocacy groups. There’s so much we can learn from patients if we just ask them, so surveys and focus groups are important. And, the conversation with patients should never end – we want to continually keep them engaged and interested. We also need to provide information to patients who participate in studies. Any information that can be shared on study progress, personal medical charts and labs, a lay summary at the conclusion of the study, and other research being done in the same indication, would all be of interest to patients.