Building stronger relationships between sites and sponsors leads to accelerated recruitment, increased diversity, and better patient engagement.
It’s time to rethink the role of sites in recruiting for clinical trials. Local sites have the specialized knowledge of their communities necessary to accelerate recruiting and enrollment, increase diversity, and keep patients engaged through the entire experience.
On February 18, Inato’s CSO Liz Beatty sat down with Rebecca Little, Executive Director of Specialty Sales for Site and Patient Solutions at Accellacare, and Matt Lowery, Executive Director at Clinical Research Business Development Plus, to discuss the evolving role of sites in recruiting for clinical trials and top strategies for building stronger relationships with sponsors.
Impact of COVID-19
Of course, the first concern for sites facing the COVID-19 pandemic was ensuring patient and staff safety. Little said they immediately put processes in place to add more time between visits for cleaning and added proper patient screening before visits. However, even with these added precautions, patients were hesitant to come in person. This is where sites had to find new ways to meet their patients where they were.
“Because we’re quarantined, patients don’t necessarily want to come to the site,” Little said. “We had to shift a little bit to look at telemedicine visits and home visits.”
Little mentioned that Accellacare has various site models, and several of them are either embedded or integrated. She said the changes that they made to their treatment delivery in light of COVID-19 have increased the retention rate.
“It’s a lot easier to keep patients when they can just do a telemedicine visit,” Little said. “Looking at it through the patient’s scope has helped as well - you may be able to recruit a patient, but if you can’t retain them, it’s lost.”
Top Strategies for Recruiting
When it comes to recruiting patients, Lowery said his tried and true technique is being as transparent and flexible as humanly possible with the people participating in studies. At the sponsor level, he said the uncertainty around running trials during a pandemic has caused a paradigm shift from sponsors saying, “Here’s what we want you to do,” to “What works for you”.
“That was a huge breath of fresh air,” Lowery said. “Instead of something coming down as a mandate, it was coming down as ‘how can we work together to get this done.’”
Lowery said that although his site is not embedded, they are still heavily involved with the doctors and try to make research as enjoyable as possible. He has found this is the best way to be able to recruit patients.
“If everyone knows what’s going on in research, that increases the number of people who might remember we have the studies going on and find good patients,” Lowery said.
Lowery added that they do everything from printing out paper versions of the current studies lists for physicians to flip through, to sponsor education sessions and ice cream socials. “Whether it’s an internal strategy or something that you’re doing in the community, you have to have a long-haul mentality since it takes time and effort to create these relationships if you want them to show results,” he said.
The doctor’s interest and excitement for the trials trickles down to their patients. “Patients who participate in our studies are going back to their friends and during social hour, they’re bragging about the studies that they’re in. If everyone is enjoying it and having a good time, it kind of takes on a life of its own.”
Little agreed and said this mindset has been critical for recruitment. “When you have a good experience, they’ll go out to their family, their friends, their community, and drive them right back to you. It’s a very important strategy.”
Diversity & Inclusion
When thinking about diversifying patient populations, Little shared that because her team is part of a global network, they are able to look at studies on a larger scale. She has access to their databases that break down into the various diverse populations so they know how to evaluate them. “We’re looking at diversity of the population but also investigator diversity, and then really diving into communities and working with various groups if they’re not in our database.”
When thinking about increasing diversity in trials, Lowery said instead of trying to jump right into a community, his site works to find organizations that support the community and establish trust that way. “With some of these populations, you have to work very hard to get a foothold - some have been taken advantage of in the past.”
Beatty shared that diversity and inclusion is a big focus at Inato and when speaking with sites about how to help increase diversity, we’ve continuously heard that this is not a study-specific issue. This is an ongoing relationship, this is an effort around building trust.
“When you’re working in the community, what it boils down to is establishing those relationships,” Lowery said. “You could have all the printed materials in the world, you could have radio commercials, TV spots, but if you have not gone out of your way to establish a long-term relationship, it’s not going to be as effective - it’s going to be noise.”
Little added that it would be great to have sponsors that are engaged with all the various communities, not related to one particular study, so they can work together to drive and develop relationships.
Beatty shared that Inato has heard from sites that they would like to rethink recruitment dollars. Historically, they tend to be study-specific, but the work sites are doing on diversity and inclusion in the community isn’t study specific. Lowery added it would be better if sponsors were a little more flexible when it comes to those ad dollars and let the site have a say in how they’re spent.
Increased enrollment speed
Little said the key to increasing enrollment speed is early engagement and transparency between the sponsors and sites. In her experience, sites are typically brought in as the trial is being started or when the need is there, but earlier communication would allow the site to begin preparing and identifying potential patients.
“Bringing us in earlier trickles down and increases all aspects of clinical research and makes them go faster - and that includes enrollment,” Little said.
Lowery agreed and said as soon as they hear about a study, they start a waiting list. “I love it when we get the green light to start and we already have 10 people lined up,” he said.
Little said this methodology is better for sites even if they aren’t ultimately selected for the study. “From our perspective, it’s a win-win. If we are selected, we’re set up and ready to go. If we aren’t selected, it’s still a win because we’ve built-up our community engagement and had touch points with these patients who we can stay in touch with.”
To hear all of the insights shared during the session, view the full recording here.
Inato allows biopharmaceutical companies to increase the pool of available patients engaged in their clinical trials by connecting them with untapped research site potential. The company powers the first global industry marketplace, which reimagines the clinical trial recruitment funnel by matching clinical research sites to the right trial protocols.