Survey Results Full

w w w . t h e m r n . c o . u k

Recruitment and retention

survey results and analysis

w w w . t h e m r n . c o . u k© Medical Research Network 2007

Survey objective

• To ascertain the perceived importance of

Recruitment and retention as issues facing

trials today

• To determine the perceived cost effectiveness

of tools and techniques used to enhance

recruitment and retention today


Objective One

Importance of the Recruitment

and Retention compared to other

issues facing trials today


Tools assessed in order of

frequency of use1 = In house Investigator database

2 = Site training

3 = Site resources

4 = Creating a referral network

5 = Referrals form advertising in medical press

6 = Site administration tools

7 = Research Networks

8 = Direct to Patient advertising

9 = 3rd party investigator databases

10 = Patient reminders

11 = Call Centres

12 = Direct to patient websites

13 = Trial specific web sites

14 = In house patient databases

15 = 3rd party patient databases


Boston Chart results

1

2

3

4

5

68 98

10

11 12 713 7

14

15

Percentage of respondents

reporting perceived as

moderately to very cost

effective

Percentage of

respondents

expecting

improvement in

recruitment of

40% or more

30

20

10

50 1000

X X = type of tool

Size = frequency of use


The Questions

• Please list what you would consider the three

most important issues/challenges in clinical

trials today.• Free text in three boxes labelled I, II, III

• Please rank patient recruitment as an issue• High importance, moderate importance, average

importance and low importance

• Please rank patient retention as an issue• High importance, moderate importance, average

importance and low importance


Results

Answers were were grouped into 24 groups within 4 classes.


Results

We analysed all the issues reported both together and in tiers (I,II and III). Results

are shown in table 2 for the top 7 issues raised.


Conclusions

• Recruitment comes out as the major challenge of all, occurring 53 times

(25%) in the 212 responses.

• The top 3 accounted for 103 or 48% of the total. In addition to recruitment,

these were Cost and Delays

• When only looking at the second tier answers, Retention rises to 2nd and

Site Quality to 3rd (Cost and Delays having mostly been reported as the

first tier issue).

• Cost, although 2nd overall was 3rd as a first tier challenge and 1st as a third

tier issue – perhaps indicating that cost is important but not to the exclusion

of success or quality

• Leading to the second objective of the survey, tools and techniques which

focus on recruitment and retention (often the same tools) are targeted at two

of the top 6 issues facing trials today


Objective Two

Cost Effectiveness of tools for

Recruitment and Retention


Tools assessed in order of

frequency of use1 = In house Investigator database

2 = Site training

3 = Site resources

4 = Creating a referral network

5 = Referrals form advertising in medical press

6 = Site administration tools

7 = Research Networks

8 = Direct to Patient advertising

9 = 3rd party investigator databases

10 = Patient reminders

11 = Call Centres

12 = Direct to patient websites

13 = Trial specific web sites

14 = In house patient databases

15 = 3rd party patient databases


Boston Chart results

1

2

3

4

5

68 98

10

11 12 713 7

14

15

Percentage of respondents

reporting perceived as

moderately to very cost

effective

Percentage of

respondents

expecting

improvement in

recruitment of

40% or more

30

20

10

50 1000

X X = type of tool

Size = frequency of use


Results 1

• The most effective tools reported, scoring highly

for frequency of use and cost- effectiveness

and absolute effectiveness.

– In house Inv database

– Site training

– Site resources


Results 2

• Creating referral networks scored highly for

effectiveness but was less cost effective and used less

frequently

• Patient reminders are cost effective and have high

absolute effectiveness, but are used less frequently

• Patient databases are seen as effective but expensive

and used less frequently.


Results 3

• In the moderately effective category were site

admin tools – also seen as moderately cost

effective and used a moderate amount of the

time.

• Similarly effective but less commonly used and

less cost effective were direct to patient

advertising and third party investigator

databases


Results 4

• Least effective and least commonly used were

– Call Centres

– Direct to patient web sites

– Trial specific web sites for enrolled patients

– Third party patient databases

– Research Networks

• Oddly this last group, although regarded as ineffective

and with low cost effectiveness, they are moderately often

used.


Results – Cutting edge survey

• Only 50% of companies incorporate recruitment

strategies in protocol design – and only 17% for

devices companies

• Only 15% of companies have a dedicated

patient recruitment group

• Most (90%) large Pharma keep the role

responsible for recruitment in house

• 50% of all other companies give this role to

their CRO



5

6

7

8

Somewhat

effective

3.6 to 6.9

Very Effective

7 to 10

Evaluating the site

Training the site

Recruit at point of care

Patient referrals contacts actively

Referral Networks

Population research

Medical Liaison

News paper ads

Recruitment kits

Advocacy groups

Community Outreach

Web advertising

On line patient resources

Radio advertisingCall centres

Score



• Patient Motivators reported as– Increased access to or improved therapy or medical care

– Convenience of sites

– Free medications

– Low number or frequency of visits

– Short trial duration

– Transport compensation

– Monetary compensation

– Non monetary incentive



• 6 of the 17 tools evaluated had NO focus on

any of the patient motivators

• 5 more effected only one motivator – increased

access to therapy or care

• 4 more affected two motivators

• 1 affected three motivators – Referral Networks

• 1 affected four motivators – Home Trial Support



• Looked at the other way

– Increased access to therapy was addressed by 7

tools

– Transport cost reduction / compensation was

addressed by 4 tools

– Convenience and non monetary compensation was

addressed by 3 tools

– Frequency of visits was addressed by one tool

– Free meds, monetary compensation and short trial

duration were not addressed by any tool


Conclusion – combined

• Tools used tend to focus on increasing patient

numbers

• This is expensive and therefore becoming

outdated

• The patient funnel needs to be widened at

every level,

– not just have more patients chucked in the top

– but opening up the bottle necks at the bottom

– both together could impact hugely


Recruitment Funnel

20 remain

Lab Screening

10 remaining

1000 total pool

Protocol restrictions

Consent and

Resource limitation

5 remain

Retained

4 finish

Patient

Motivators and

Site Resources

Number of patients

at each level


Hierarchy of Need

Recruitment

Minimum patients in core site

database

Maximum patients in core site

database

Patients accessed through

extending site reachTo

talpatient

recru

itm

ent

pote

ntial

12

4 5 6 7

1 – Open up protocol restrictions

2 – Add resources to site to

manage available patients

- Site Support,

- Some software tools

- Recruitment kits

3 – Train Sites

4 – Create extended patient

referral network

5 – Advertise – radio, newspapers etc

6 – Web presence / tools

7 – Home Trial Support

3


Hierarchy of Need

Retention

Minimum patients retained for full

therapy period

Maximum patients retained for full

therapy period

Tota

l patient

rete

ntion

pote

ntial

8 9 10

8 – Improve interaction with patients

Pt reminders

Pt support materials

Rx Follow up

Transport assistance

Caregiver support

9 – Improve site motivation / commitment

10 – Home Trial Support

Survey Results Full

Documents

Transcript of Survey Results Full