Patient retention is the strategy & tactics designed to keep participants enrolled in clinical trials, reducing the chance of them discontinuing. It is measured by the ability of healthcare providers to keep patients engaged in their care and coming back for future appointments.
The main factors that contribute to the failure of 90% of clinical trials
- Lack of Clinical Efficacy. The most common reason for clinical trial failure is that the experimental treatment does not demonstrate the expected therapeutic effect. This could be due to flaws in the drug’s design, unexpected biological responses, or the disease being more complex than initially understood.
- Safety Concerns. Even if a drug is effective, it may cause harmful side effects that outweigh its benefits. Unexpected toxicities or adverse reactions can lead to the early termination of a trial.
- Patient Retention and Recruitment Issues. Difficulty in enrolling enough participants or keeping them in the study can undermine a trial. Delays in recruitment or having to re-recruit after losing patients due to poor retention can lead to increased costs and logistical issues.
- Costly Delays. Delays in trial progression, whether due to regulatory hold-ups, operational inefficiencies, or poor patient retention can all lead to significant time and cost burdens inflating costs and leading to the abandonment of the trial.
Some of the key barriers to maintaining a high level of patient retention
- Burden of Participation. If the trial requires frequent visits, complex procedures, or extensive time commitments, participants may find it difficult to adhere to the protocol.
- Life Changes. Changes in a participant’s circumstances, such as moving to a new location, changes in job, or family responsibilities, can make continued participation difficult.
- Financial Costs. Although participants are usually compensated, out-of-pocket expenses such as travel, parking, or time off work can become a deterrent.
- Lack of or Inadequate Support. Participants who do not receive adequate support, such as help with understanding procedures or managing side effects, may become frustrated and leave the trial.
How to address the barriers to maintaining a high level of patient retention in clinical studies
Researchers and trial sponsors can implement several strategies:
1. Reduce the Burden of Participation
- Simplified Protocols: Design study protocols that minimise the frequency of visits, reduce the complexity of procedures and streamline data collection to make participation more convenient.
- Decentralised or Remote Trials: Utilise telemedicine, home visits, or mobile health technologies to allow participants to complete some or all study activities from home, reducing the need for travel.
- Flexible Scheduling: Offer flexible appointment times, including evenings and weekends, to accommodate participants’ work and personal schedules.
- Site Location Considerations: Select study sites that are geographically convenient for participants, or establish multiple locations to reduce travel time.
2. Accommodate Life Changes
- Relocation Support: Offer options for participants who move to continue their participation at a different study site, or transition to a remote participation model.
- Adaptive Study Design: Allow for adjustments in the study protocol to accommodate changes in participants’ life circumstances, such as reducing the frequency of visits or allowing virtual follow-ups.
- Regular Check-ins: Maintain regular contact with participants to understand their changing needs and adjust the study involvement accordingly.
3. Mitigate Financial Costs
- Travel and Expense Reimbursements: Provide full reimbursement for travel, parking, and other out-of-pocket expenses associated with study participation. Consider offering prepaid cards or covering these costs upfront.
- Compensation for Time: Ensure that participants are adequately compensated for their time, including offering compensation for missed work or providing stipends that reflect the time commitment required.
- Local Study Sites: Whenever possible, choose study sites close to where participants live or work to minimise travel-related expenses.
4. Enhance Support for Participants
- Dedicated Study Coordinators: Assign each participant a dedicated study coordinator or contact person who can help with scheduling, answering questions, and providing emotional support throughout the study.
- Clear Communication: Ensure that all participants fully understand the study procedures, risks, and benefits through clear, jargon-free communication and provide them with easy access to study documentation.
- Access to Healthcare Professionals: Provide participants with easy access to healthcare professionals who can help manage side effects, answer medical questions, and address any concerns that arise during the trial.
5. Enhance Participant Engagement
- Regular Updates: Keep participants informed about the study’s progress and any relevant findings to help them feel engaged and valued.
- Participant Feedback Mechanisms: Implement regular feedback mechanisms, such as surveys or interviews, to gauge participant satisfaction and make adjustments to the study based on their input.
6. Personalised Participant Care
- Tailored Communication: Use personalised communication strategies that acknowledge participants’ individual circumstances, preferences, and motivations for joining the study.
- Cultural Sensitivity: Ensure that the study design and interactions with participants are culturally sensitive and inclusive, respecting diverse backgrounds and needs.
How mdgroup improves patient retention
mdgroup provides services that facilitate and reduce the burden of participation and vastly improve patient retention by ensuring that patient’s needs are considered at every stage. The patientprimary division comprises three key services that reduce patient dropout rates ensuring that they are prioritised before and during a study.
ondemand brings the patient to the trial
ondemand encompasses personalised concierge support, compliant travel, accommodation and logistics, expense management, reimbursements and stipend payments. This service ensures that patients are brought to the trial with the assistance of its dedicated team of navigators, reducing the burden on them. By paying close attention to the little details that make a significant difference, they collaborate with clients to drastically reduce patient drop-out rates and facilitate exceptional experiences at every clinical trial stage.
mobilehealth brings the trial to the patient
mobilehealth facilitates remarkable experiences within the comfort of patients’ own homes or locations of choice. Decentralised and hybrid clinical trials provide greater flexibility for patients to participate in studies on their terms, which has a direct positive impact on recruitment and retention rates and significantly improves clinical outcomes.
navigator supports patients at every step
Bringing all of this together is the navigator service, which simplifies the clinical trial journey for patients. This service provides personalised support for patients across the ondemand and mobilehealth services. Well-versed in making the right decisions and choices with the patient in mind the dedicated navigator team reduces the burden on trial participants by understanding their unique requirements and preferences. They provide a bespoke service to patients throughout their clinical trials – whether the visit takes place at the site or remotely. This white-glove level of support significantly reduces patient drop-out rates.
mdgroup provides these services because patient-focused trials recruit up to double the number of patients and the products developed are more likely to be developed if patients are happy.
Happy patients are more engaged and are likely to stay in a clinical trial until completion. This in turn makes for better retention as well as turning the participating patients into strong advocates and promoters for future medical research.
