Why your clinical trial recruitment strategies are failing on social media

How do you find patients to participate in clinical trials if you don’t know the problems those patients need to solve and what they already think of their current treatment plan? The answer is that you can’t, and you won’t.

The clinical trials industry has a lot to learn from fast-moving consumer goods (FMCG) in terms of driving what the customer wants to think and feel. Just as Nike sells motivation (“just do it”) and not shoes and iPods were about freedom and personalisation instead of just music, clinical trial recruitment advertising and communication must tap more into the hearts and minds of what patients want instead of what investigators need.

We also have a lot to learn from the hospitality industry in terms of customer service and responsiveness. Customer experience is critical to success in hospitality — it’s not only dinner that people buy in restaurants, after all. A venue’s atmosphere, service, and timing are a big part of making customers feel special, respected, heard, and valued. The same idea also applies in clinical trials to encourage trust in patients to participate in a trial.

The message is too focused on what clinicians need and not on what participants want

“Volunteers wanted” was the first thing I read on a study recruitment ad in my Facebook feed this morning. “Clinical trial of existing medications (oral or topical) for hand osteoarthritis” was the next line, with an image of two elderly ladies knitting. A comment by an applicant states that they applied and were turned down, but for over twenty-four hours this comment had been left hanging, with no reply or engagement from the study team. No moderation is a red flag for any other participants who might consider clicking on the link.

Aside from this lack of human interaction, there is nothing in this recruitment advert that speaks to the patient — it’s impersonal and clinical. The value, benefit, importance, and urgency of their participation is not articulated, and the ad’s message is too broad, using language prospective participants may not understand, not to mention speaking in the third person. As for the ad’s image, not everyone with osteoarthritis is elderly or knits. The biggest challenge someone with osteoarthritis of the hand may have is probably holding a cup of tea or eating with chopsticks or a knife and fork and this can affect people of all ages.

Working in pharma marketing for years has taught me several lessons when it comes to emotional messaging. The goal is to design a message that reflects what a person identifies with or how they feel, to create something relatable to the person. It’s not always an easy thing to do, but applying design thinking principles such as empathy mapping to the message creation process goes a long way in terms of crafting high impact copy that speaks and inspires participants to click. 

You are not using content that inspires trust

Signing up for a clinical trial or study requires a patient to place their trust in the investigators. When asked why they signed up for a trial or study, many participants will echo the sentiment, “I trust my doctor and they recommended I participate,” or “it’s being run at a hospital I’m familiar with already.”

Patients typically trust their doctor, so having video footage of a clinical researcher describing the importance of the trial or study and what is involved is both compelling and ultimately reinforces a perception of trust.

Identifying the institute or hospital site is another way of establishing trust — medical researchers and public hospital physicians enjoy a very high approval rating in most countries in terms of trust and integrity. 

Syneos undertook a study in 2018 examining the effectiveness of digital advertising related to clinical trial recruitment. The study identified that participants who were likely to click through a social media ad typically had relatively high trust in the digital environment and the information source. YouTube was identified as the most trusted online platform amongst the 432 patients in the study, so it should be no surprise that video content is starting to play a big role in e-consent platforms, ultimately inspiring greater trust, understanding, confidence, and better consent rates. So why don’t we use video more in Facebook advertising?

The message is not being shared in the right places

The study also demonstrated the recall rate of clinical trial advertising was highest on television, Facebook, and their doctor’s office waiting room – and in that order. Online patient communities were a strong source for clinical trial advertising recall, particularly if it was a community associated with a rare condition with few treatment options and in which the community is relatively small and online activity is intense. Not all patient communities use social media platforms in the same way and clinical trial recruitment advertising may be very unwelcome in some digital communities. Patient advocates and community moderators/owners are critical in making sure the value and benefit of a trial or study are communicated appropriately. They know the language of their communities best and have a far more sensitive and accurate radar in determining how to best approach the community and what value proposition is likely to resonate.

If I had a dollar for every time I’ve heard clinician-researchers suggest that older people are not on Facebook, I’d be a very wealthy woman. The over-65 age group are the fastest-growing demographic on social media. Not all social media platforms are equal as well — different demographics use social media networks in different ways. We have seen significant cultural differences when recruiting for the same study in Australia as compared to South America or Thailand, for example.

One of the hardest populations to recruit to a study are teenagers and young adults. Many assume that because teenagers are digital natives they are obviously also on social media, but I’m confident in saying that developing a social media recruitment campaign for young adults would have to be one of the most difficult tasks that our team faces. Even though we have a few 20-somethings in our company, we spend considerably more time searching, thinking, experimenting, and strategising with this population than any other.

A final word on advertising budgets

The big question I get asked almost every week is “how much will this cost?” which is probably the hardest question to answer as the cost of recruiting is directly related to the inclusion criteria, size of population, therapeutic area of interest, the social media platform of choice and how many competitors are recruiting in the same space. Working out how big the “sales” funnel is as well as the attrition rate as viewers of your recruitment advert move from awareness to contemplation, and finally to consent is not a “one size fits all” process. Experimenting with the population you are trying to recruit by doing split testing or A/B testing will give you the best answer of ‘how much’. Suffice to say, as the recruitment campaign gets underway and participants respond to the most relevant copy and incentive to click, the cost per click should decline and become more affordable with time and success. And as each successful recruitment campaign is done, the learning and value is transferred to the next campaign, and so on.

This article was written by Opyl CEO, Michelle Gallaher. 

[1] Syneos (2018): Content That Clicks: Effective Social Marketing for Clinical Trial Recruitment

About The Writer

Michelle Gallaher is an award-winning health technology entrepreneur, speaker and advocate. As CEO of Opyl Ltd (ASX: OPL), a company working at the intersection of social media, clinical trials, and artificial intelligence, Michelle is leading a team seeking to improve the efficiency of clinical trials. The first of two AI-enabled platforms, www.opin.ai launched in May. A patient-led approach, Opin leverages social media to invite patients to self-select an interest and match to any registered trial, anywhere in the world. The second Opyl platform uses predictive analytics and AI to model, inform and improve trial design. Commencing in allied health, Michelle’s 25+ year career spans startups, biotech and pharma marketing roles, national medical research initiatives and leading a biotech peak-body. Michelle is a non-executive director with Praxis Australia, Cancer Trials Australia and Medtech Actuator and co-founder of Women in STEMM Australia. Michelle is a Victorian Honour Roll for Women inductee, Victorian Telstra Business Woman and Entrepreneur of the Year, TedX alumnus and a winner of Westpac’s 200 Businesses of Tomorrow. A Fellow of the Australian Institute for Management and Graduate of the Institute for Company Directors, Michelle has an undergraduate degree in applied science, postgraduate qualifications in business and marketing.