33 - Reframing clinical trial recruitment

Imagine you are diagnosed with a condition without a simple and readily available cure.

There are plenty of these diseases out there and your mind might immediately leap towards cancer or other fear-inducing diagnosis. But there are plenty more that many of us live with day-to-day: asthma, eczema, IBS, depression, anxiety, to name a few. What do you do when your condition takes over your life, but no treatments seem to be working? Life has changed, and you cannot detach yourself from the fear that your life may never be the same again. Imagine that you had run out of options.

Clinical trials could provide you with new possibilities and hope. Clinical trials are the viable healthcare option that too few people consider. The perception that clinical trials are uncontrolled experiments done on students for some petty cash (which is held by most of society) is not the reality. They have well thought out protocols, with stringent safety measures; they offer purpose, a cause, a legacy. They hold the key to better, longer lives and can provide hope, when hope is lost. Clinical trials are the hero so often villainised by the media. They are only accessible to some: the informed. Yet, involvement in a clinical trial can offer hope of disease management and for some it is a final chance of survival.

For those in the industry this is sometimes forgotten amid the logistics of completing a trial in a high-pressure and ever-more competitive clinical trial environment. There was a 1,500% increase in the number of yearly registered clinical trials between 2000 and 2020, with over 80% of trials overrunning their intended completion date. Commercially, this is obviously problematic, but it has initiated a change of approach for trial recruiters. There is a need to inform more people and bring clinical trials into the consciousness of the public. Trial democratisation, where fewer people are excluded from the opportunities provided by medical research, is slowly becoming a reality.

The onus is on the pharmaceutical industry and the shift is not easy; clinical trial recruitment is an unforgiving communication landscape. There is a long list of things that are making conditions more and more challenging:

Clinical trials are complex in nature, yet the average reading age of the UK is just nine years old

Clinical trial site staff are busier than ever and often overwhelmed by the number of trials that they are running at their institution
The attention of patients is dominated by consumer brands
The intended clinical benefit of the drug cannot be discussed, yet the risks must be laboured
Consent feels like a binding contract yet can be removed at any moment
Decentralised trials are coming, so more technology needs adopting but the population is ageing.

The list of communication challenges in clinical trials is seemingly endless. Which goes a long way to explain why clinical trials are failing to recruit on time. But recruitment and retention challenges can be overcome by better communication.

In recent years it has become normal to build a creative and strategic communications strategy into the drug development process, to overcome such challenges. This has accelerated patient outreach through the recruitment of people into clinical trials using digital channels such as Google Ads. But, perhaps due to negative press around data usage, Facebook and other digital outreach platforms are continuing to remove media targeting using parameters such as health conditions, race and religion.

On the surface this feels like a good thing. Culturally, we are (rightly) protective of our data, but things are seldom that simple. In late November, 16 people entered a clinical trial in the US for a nasal vaccine for Alzheimer’s disease. The vaccine has showed promise over 20 years of preclinical work for a disease that currently has no cure. If my life was directly affected by Alzheimer’s disease, I would want to know more about the phase 2 and phase 3 trials, wouldn’t you?

To inform the uninformed, healthcare communications are going to have to work even harder to cut through the noise. Page & Page and Partners really are the agency that think differently (that is the reason I joined). We build scientific storytelling into compliant and ethical clinical trial communication. Our communications do not just help people understand, they make people feel and they make people act. Internally, we have framed the challenge of trial recruitment differently. Our teams do not focus on the number of patients required by our clients, we focus on the number of people who could benefit from knowing about the trial. We believe that there are people in need, that need to know, and this motivates us to deliver incredible work that helps our clients.