Tara Lauriat, PhD Tara Lauriat, PhD Guest Blogger

Clinical trial participants are worth their weight in gold: My experience recruiting for a Bipolar Depression Study

One thing I was not prepared for when I switched from laboratory research to clinical research was that I could not simply order study participants from a catalog as I did for supplies. While I had received excellent training in neuroscience, I really knew nothing about advertising. Unless I learned the ropes, it was clear that I would not be able to get enough people enrolled in the trials and would not be able to do the scientific piece. So here is a bit about my recent experience recruiting for a Bipolar Study.

In general, if you need healthy volunteers and are not doing anything invasive or dangerous, the response to a single ad on Craigslist can be overwhelming. In contrast, recruitment for our current bipolar depression trial has proven to be a more difficult task than I ever could have imagined. I have been looking for people for over a year and spent about $15,000, yet I have only found 3 eligible candidates. That basically translates to $5000 per enrolled participant. We need 30 people and obviously did not budget for $150,000 in advertising costs. While this study has been especially challenging in terms of recruitment, I am told that $1000 to $2000 a person is very reasonable.

Here is a general breakdown of strategies that I have tried (and i have earlier discussed some of these recruitment strategies in an interview with Kim@CureTalk)

Craigslist: Craigslist is a very popular way for people to learn about clinical research studies and is gentle on the bank account. The etc. jobs section is $25 per posting in major cities like Boston (not all postings are free as many people believe). The volunteers section is also an option where postings are free for 7 days.

Local Newspaper: The Metro is a free newspaper targeting commuters in Boston, New York City, and Philadelphia. The paper includes a medical research section and there are plenty of people out there who monitor it for studies. Advertising in the medical research section leads to a high call volume with almost no email inquiries. The dedicated sales representative understands the budget limitations of academic medical centers and offers a greatly discounted rate compared to the list price. However, this discounted price is still enough to surprise most people when they consider that the ad is only running for one day. If money were no object, I would try all of the other newspapers as well, since several have contacted me after seeing the Metro ads.

Mass Transit: I have also tried to reach commuters with mass transit advertising. Although it is costly, the ads stay up for a few weeks as opposed to a single day for a newspaper ad. This is not a bad approach if the budget permits, but the response is not overwhelming.

Radio and Television: I have also found ways to run affordable commercials both on television and radio. While the TV commercial was clearly low budget, it is hard to know if a pricier piece would have yielded better results. The sales reps always tell me that my ad would have worked better if had been bigger or nicer or run more times, but I am skeptical.

Direct Mail: I recently tried a mass mailing to people who had requested information on depression and bipolar trials. If I zeroed in on the target population, it seemed that I should succeed in finding the right people. I enlisted the help of a professional company that specializes in recruitment to provide the expertise that I was lacking. Their postcards looked amazing, but for some reason did not give the response that the company typically sees.

Facebook and Google: Finally, there is online advertising. The wonderful team at TrialX helped me market my trial on Facebook and other venues to drive in online traffic. I have also tried Google with ads displayed on relevant websites. The challenge with Google is that you are bidding on search terms. Since large pharmaceutical companies may be bidding on the same terms to advertise their medications with a much larger budget, it is hard to have your ad perform well unless you are willing to pay several dollars every time someone clicks. Given that most people who click on the ad don’t actually end up calling or emailing to inquire about the study, the costs can soar with little return on investment.

Other Strategies: I have sent flyers to organizations that provide support services, posted listings on advocacy organization websites at the local and national levels and college job boards, used listing services such as clinicalconnection.com, staffed a table at a walkathon, and tried to get patients from our clinic. I have called just about every mental health clinic in Boston.

I should clarify that the advertising was not a failure. People responded to the ads and inquired about the study. However, research studies have strict eligibility criteria so many people are not qualified to participate. Others decide that the study is not a good fit either because of the medication involved, the time commitment, or some other factor. There are also people who schedule an appointment and then either cancel at the last minute or simply fail to show up. Overall, I have screened well over 100 people over the phone and have had close to 30 come to the clinic for initial screenings. Considering those numbers, it is quite remarkable that we have only enrolled three so far.

  • conadmin

    i can understand the difficulties. this is one of the reasons we suggest to our clients to use our pre-screeners to screen out false-positives before hand.

    Looking at your numbers

    1. For 15,000 you screened 100 ppl on phone – that is in the ballpark region as it costs around $100-$200 to get a referral through print, radio ads
    2. Of the 100, 30 got screened – thats a pretty decent rate
    3. Out of the 30, 3 got enrolled, yielding a net 3% enrollment rate from the 100 you talked to – this is a bit lower than the avg. 5% but still not that bad

    On avg. per enrolled patient costs can go up as high as $5000/patient.

    The numbers are a bit on the higher side but not exorbitantly higher. We have had very good success in dropping the per referral cost down at TrialX and keep it below $100. We managed lower than $100/referral for your trial as well.

    I think just adding 1-2 questions in the pre-screener can help with the recruitment rate

  • Tara Lauriat

    The challenge is that when a study is funded by a small foundation or a small grant from the government, the total advertising budget may be less than $5000. Large pharmaceutical and device companies can invest in advertising, but academic researchers often do not have the resources to do that.

  • Kris

    Hi Tara, I found your article interesting and think that it reviews the clinical trial advertising options quite well. I work for ClinicalConnection.com and would be interested in hearing how the response from our website stacked up against the other things you tried both in terms of overall response and return on investment.