Best Practices Showcase: CR site: Tips for improving subject recruitment
CR site: Tips for improving subject recruitment
"Don't waste your resources"
Successful clinical trial recruitment requires a wide range of strategies, one clinical research (CR) site has found.
"You have to be savvy about where to find people," says Patricia Larrabee, RN, NP, chief executive officer of Rochester Clinical Research Inc. of Rochester, NY. Rochester Clinical Research conducts outpatient pharmaceutical trials, phases I, II, and III, and also conducts device trials.
The CR site will gear advertising to venues that have been proven to attract the particular demographic of trial participants they seek, she says.
For instance, the age group from 18 to 35 should be recruited through the Internet, she says.
"This age group isn't reading the newspaper anymore," Larrabee explains. "And people over age 65 are not necessarily going to use the Internet."
So for a study that will recruit younger adults, a site might advertise on-line on the social networking sites, such as Facebook, MySpace, or on the classified ads site called Craig's List, she says.
The advantage to recruiting on those types of Internet sites is that in addition to reaching a target demographic audience, they provide advertisers with some valuable data about this audience, Larrabee notes.
"They'll target only the people in your region, and when you receive calls, they'll give you details about those potential subjects, including their favorite TV shows and radio station," she says. "This information is available because people put this information in their profiles on the sites."
So if a CR site is recruiting for a large study and needs to know which types of advertising venues would best attract participants, the Internet social networking site's information will offer clues. For instance, calls from the Internet ads might suggest that a majority of people who called liked a particular radio station, Larrabee explains.
"Then that's where you put the radio ad," she says. "This gives you data to help find participants, and you can generalize the information for different age groups."
Recruiting should be a priority at CR sites, which is why Rochester Clinical Research has invested in fulltime recruiters and in software that helps to track recruitment responses and participant data, Larrabee says.
"One of our initial philosophies was to take preliminary histories over the phone," Larrabee says. "But we've changed that model."
Now the CT site hires recruiters who were trained as customer service representatives for insurance companies or who were medical secretaries, she notes.
"They're used to high-volume situations, talking to a lot of people," she explains.
Recruitment involves cold-calling, which didn't interest nurses, Larrabee notes.
With demographic information from the Internet and the CR site's database of potential subjects, it was no longer necessary to have nurses conduct pre-screening by telephone. Trained recruiters can do this, and their cold-calling follows a preliminary recruitment letter, she says.
"We find it works better with cold-calling to send all people who have diabetes, for example, a letter saying we're looking for people to enroll in a diabetes study," Larrabee explains. "Then when you call them they're not surprised and will talk with you."
Recruiters are well-trained, and CR supervisors meet with them each week to make certain they understand what the study requires, she adds.
CR sites typically are given slender budgets for recruitment efforts, so it's important to use the money as efficiently and wisely as possible.
"So you should make sure you have properly-trained personnel, and it helps to have software that helps you analyze data," Larrabee says. "Don't waste your resources, so know your target audience and how things are changing."
A good example of how the database can be used efficiently involves a study that will recruit people with severe heartburn, she says.
"People who smoke and drink are more likely to have severe heartburn, so we target smokers and drinkers," Larrabee says.
"For a study of an isometric exercise device, we found people who exercise in our database and also targeted marketing efforts to local YMCA newsletters," she adds.
Technology has played a big role in recruitment.
"Our searchable database, Clinical Conductor software, has been huge in helping us find where to put our focus," Larrabee says. "We have 20,000 names and their demographic information on it."
For instance, if a CR recruiter wishes to find potential participants who have diabetes and a body mass index of less than 35, she can look within those parameters for a list of people to contact.
"The software also figures out how many people responded to a certain ad, and the software ranks the different marketing efforts we've made," Larrabee says. "It shows who called and what kind of response we received."
For example, a radio ad might solicit 90 phone calls, but too few actual study participants.
"You need metrics; it's all about numbers," Larrabee says. "Each contact is collated and sorted and tabulated."
With the software database, Larrabee can easily find out how much a particular advertising venue cost per person screened and per participant enrolled.
The trained recruiters follow a telephone screening script that is approved by the IRB.
"The study coordinator submits it to the IRB for review, and then when it's approved the recruiters use it as their guide," Larrabee says. "If we do pre-screening by telephone, we ask people if we can put their information in a database, and then we ask them questions about their health care."
The pre-screening interview typically includes a basic health history, person's weight, medications, body mass index range, blood pressure, and the last doctor visit.
"Then we schedule appointments for the people who meet criteria," Larrabee says.
Successful clinical trial recruitment requires a wide range of strategies, one clinical research (CR) site has found.Subscribe Now for Access
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