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Digital recruitment for clinical trials

As more patients go online for health, digital channels are showing ever-greater promise
Pfizer OAB virtual clinical trial

There is strong industry interest in exploring how digital channels could improve clinical trial recruitment rates - a costly and time-consuming issue for pharma.

The hope that using social media, mobile apps, dedicated trial search sites or other digital technology to connect patients and studies quicker and more cheaply has grown inline with the possibilities afforded by the technology.

But it's important to avoid overhyping the place of digital. Taking Europe as an example, the region is home to a steadily growing minority of people who go online to search specifically for health information, but they are still a minority. The European Commission says, in the latest figures it has published, that the number of people who go online for health information in Europe more than doubled in the six years to 2011, but still only comes in at just over 38 per cent.

The pictures gets more interesting when you look at who might be exposed to health messages even if they're not actively seeking them out. The same EC statistics show that in 2011 more than two-thirds (67.5 per cent) of people said they made regular use of the internet, going online at least once a week. Within that population just over 56 per cent of people describe themselves as frequent internet users and say they surf the net either every day or almost every day.

Add in the exponential growth of people who use social networks or mobile devices and a picture builds of a fragmented online landscape where patients, potential patients, and their friends and relatives are more than likely to be online in one form or another.

Lessons from digital health

With a significant number of people going online for health information it's no a surprise to see increasing numbers of firms grappling with the best way to target the online population. But what have they learnt?

First of all, digital can work. A study of Facebook last year concluded that social networks have potential when it comes to recruiting participants for clinical trials.

The study's Facebook advert ran for five months and invited females aged 16 to 25 from Victoria, Australia to participate in a health study. The ad was clicked on by 551 women, at which point they were taken to the study's website where they could submit their contact details, and 426 subsequently agreed to complete a health-related survey. Of those who agreed to take part, 278 completed the survey (139 at the study site and 139 remotely).

Writing in the Journal of Medical Internet Research the researchers said that at an average cost in advertising fees per compliant participant of US $20 the approach was “highly cost effective”. Despite some limitations in terms of lower participation rates than traditional trials and some potential for participant bias, the study population was still demographically similar to the general population of 16- to 25-year-old females from Victoria.

But clinical trial adverts like these, or even those heard on music streaming service Spotify, largely replicate an offline experience, whether it's that of print or radio adverts. The digital story gets a lot more interesting when it comes to channels that can only exist online.

Clinical trial search

PatientsLikeMe online clinical trial search 

There are an increasing number of clinical trial search services, either run as standalone businesses or as additions to existing ones. One new clinical trial search engine launched in April. MyClinicalTrialLocator.com aims to make it easier for patients to find studies and to help researchers recruit suitable trial participants, largely by making publicly available information from the US government's clinicaltrials.gov site more user-friendly.

Another similar service, TrialReach, bills itself not as a clinical research company but as an internet one and says its goal is to “democratise the information and access to medical research”. To help it achieve this the company recently partnered with Patient.co.uk, a leading UK health information website, in a deal that will greatly expand access to TrialReach's clinical trial search tool.

A yet-more advanced model is that developed by online community PatientsLikeMe, which built its audience first and then expanded into clinical trial search. PatientsLikeMe this year signed up Sanofi and inVentiv Health as clients for its clinical trial search tools to match patients to studies.

Pharma and digital

Qu Biologics Twitter clinical trial 

Efforts to harness digital channels for patient recruitment to clinical trials are still at an experimental stage, with CROs and pharma often trying similar tactics, from working with online communities to utilising social media.

Canadian biopharma Qu Biologics is one of those tapping into social media to boost trial participation. The Vancouver-based firm's ongoing phase I/II trial of its novel Crohn's disease treatment has dedicated Twitter and Facebook accounts, both of which share information about the trial as well as general information on Crohn's disease.

Big pharma too has been experimenting here. In 2011 Lilly piloted social media recruitment for trials in diabetes and head and neck cancer that achieved what the company termed a “meaningful volume of responses”, while enabling it to make cost savings of 10-15 per cent though the elimination of multiple project fees. “Social media is now on the map for Lilly,” Sara James, global enrolment consultant for Europe at Lilly Research Centre, told an industry conference last year.

Even Pfizer, whose much-lauded, yet ultimately unsuccessful, 'virtual trial' used a dizzying experimental combination of new mobile technology, social media and other online channels, has vowed to keep trying to find the best way to harness digital for trial recruitment.

“This project does not represent a failure for, or withdrawal from, the use of the internet or social media for patient recruitment,” Pfizer's head of clinical innovation Craig Lipset said in 2012.

When it comes to digital, firms will have to keep experimenting with different permutations of on- and off-line technology and routes to the patient. But it's clear that as patients go online for health in ever-greater numbers, while the jury may be out on the best way to harness digital, the verdict on its potential is long since in.

16th December 2013

From: Research

16th December 2013

From: Research

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