Clinical trial recruitment and retention: rising or falling?

Clinical trial recruitment and retention

First up, the good news

Over the past seven years, clinical trial recruitment rates have been on the rise.

Let’s take a closer look at the details…

The Tufts Center for the Study of Drug Development (CSDD) collected data on 87 clinical trials from four top-20 pharma companies and one global CRO, comparing the 2019 metrics from 2012. And they found some amazing results:

  • Actual enrolment exceeded planned enrolment in 2019 by 113%, compared to 2012 when trials achieved an average of only 96% of planned enrolment

  • Sites are recruiting faster, with 77% of trials now hitting or beating planned timelines, compared to only 47% previously

  • Trials in North America had the highest planned-to-actual enrolment ratio vs the rest of the world

  • Both North American and Asia/Pacific trials achieved an activation rate of more than 85%

  • Of all sites studied, 87% of proposed early-stage trials, and 85.7 percent of late-stage trials, were able to begin recruiting

  • Respondents’ average number of sites activated in 2019 was 30.5 in North America, 30.1 in Eastern Europe, 27 in Western Europe and 12.5 in Asia/Pacific.

Amazing, right? And according to CSDD, patient involvement in protocol development, mobile data collection devices and virtual trials all contributed to improved recruitment metrics since 2012. It just shows that all the hard work we’re doing as an industry to improve patient recruitment strategies really is paying off.

The hard truth

But, the bad news? Retention rates are falling.

When comparing the 2019 metrics from 2012, CSDD found:

  • In 2019, trial dropout rate rose to 19.1% from 15.3% in late-stage trials globally, with the highest rates occurring in central nervous system (CNS) and oncology trials

  • CNS trial dropout rates grew to 25.9% from 19.2

  • Oncology trial rates grew to 19.3% from 18.2%

  • Vaccine trials experienced a 12.3% dropout rate in 2019

  • Cardiovascular and rare disease trials fared best, with rates of 7% and 6.5% respectively

So, it looks like while recruitment rates have been on the up, this hasn’t translated over to retention. This does make sense when you consider that some companies work so hard to get participants onto their trial in the first place; it can often be forgotten to work on the rest of the patient experience too. And the hard truth is, just because more patients are signing up to take part in a clinical study, there’s nothing stopping them from leaving. So, that’s why retention strategies are just as important as recruitment.

Onwards and upwards

With retention rates taking a serious hit according to the CSDD study, it’s time to make a change. Luckily, there are ways that you can make the experience better for patients and help them want to stay on the study. Here at COUCH Health, we can help you with strategies to do this.

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