For decades, we have accepted that patient enrollment is the source of delays with cost implications that can make a trial fail.
10 years ago, social media may have seemed too unknown for clinical trial specialists to involve in recruitment.
Independent tests performed over the last five years now support its credibility as a digital tool that reliably cuts costs, improves timelines and offers further benefits through patient relationships.
Evolution of the approach to recruitment is now following the pattern of commercial marketing to embrace social media, just more slowly.
A US study, conducted in 2009 and published in 2010, correctly predicted social media’s great potential to facilitate recruitment (Applied Clinical Trials, 2010).
During June, July and August of 2009, the investigators compared the efficacy and cost of three direct outreach approaches to patients with rheumatoid arthritis and multiple sclerosis: direct mail to a third-party contact list, email to a third-party contact list and contact via the social network http://iGuard.org/, an internet-based service for monitoring medication.
Specifically, they identified the proportion of outreach attempts that led to completion of their online survey – considered to represent interest in a clinical trial – and the cost of a single such interest.
Patient recruitment cost
Analysis of the results suggested that direct mail outreach generated a response by 3.6% (n=905) of patients (905/25,000), of whom 78% were interested in enrolling in the clinical trial. At a unit cost of 86 cents ($0.86; 0.64 euros; £0.51) per direct mail outreach, the cost per person interested was $30 (22.35 euros; £17.84).
Email outreach generated a much lower response rate than direct mail at 0.5% (n= 157) of the 30,000 people approached. However, the rate of interest per outreach was very similar at 80%, giving a cost per recruitment interest of $100 (74.51 euros; £59.45).
The http://iGuard.org/ strategy polled 3657 members during the study period. Of these members, 482 responded (13.2%) and 75% of responders showed interest in the trial. This gave a much reduced unit cost per interest, at $4.25 (3.17 euros; £2.53)– just 14% of the cost per interest of direct mail and 4% of the cost per interest of email outreach.
Social hits clinical
As we enter a period of ‘patient-centricity’, in which pharmaceutical companies are desperate to sell themselves as being patient focused, it is unsurprising that the demonstrated benefits of social media for clinical trial recruitment are becoming absorbed.
Patient communities are a prime source of potential trial candidates as high numbers of patients with chronic conditions are drawn to these communities to learn about their diagnosis, share their concerns and stories, and gain peer support.
One company that has embraced the potential of these patient hubs is MyHealthTeam, which hosts digital platforms for people suffering from breast cancer, multiple sclerosis, Crohn’s and ulcerative colitis, and autism.
Administrators of these four platforms are ideally positioned to identify those patients with these chronic diseases who exhibit the precise profile sought by a pharmaceutical company or contract research organization for clinical trials.
Pick of the bunch
Better still, they can select those patients with the right disease features who are located in the right area – close to a centre running the trial.
Community members who are selected in this way and who have also given consent to be contacted by the community administrators are sent a private email, inviting them to take part in a pre-screening survey, the website Applied Clinical Trials reports. Members who pass the screening survey are asked if they would like to be contacted by the pharmaceutical company.
Proof in practice
The benefits of this patient-friendly approach are demonstrated by the experience of pharmaceutical company Biogen Idec (Eyeforpharma, 2014). Before partnering with MyHealthTeam, Biogen Idec screened about six patients per week for potential inclusion in a clinical trial. After the partnership was formed, the number of patients screened rose to 800 patients in just two weeks.
Social media looks poised to launch into a principle role within patient recruitment. Currently only 11% of trials take advantage of this shortcut to patients. Biogen Idec found that social media generated a first-wave response rate of 15% – a nudge greater than the 13.2% response rate achieved using http://iguard.org and reported in 2010. They say this is a reliably higher response than traditional outreach programmes.
Combined with the lower cost of social media outreach and the fact that delayed recruitment so often drags the time to product launch and hence the period of market exclusivity, social media looks highly promising.
We are keeping our eyes firmly on this space and encourage you to seriously consider the benefits of social media for your own trials.
Applied Clinical Trials (2010) Direct-to-patient enrollment strategies: http://www.appliedclinicaltrialsonline.com/appliedclinicaltrials/CRO%2FSponsor/Direct-to-Patient-Enrollment-Strategies/ArticleStandard/Article/detail/686202
Eyeforpharma (2014) Social media on trial: http://www.eyeforpharma.com/patient-clinical-trials/social-media-on-trial.php