Recently, I was speaking with a person working on a clinical trial for a rare brain disorder. The symptoms of this disorder are subtle and they wax and wane, which was making it hard to locate patients eligible for the trial. When I asked how they were identifying potential trial participants, the person described a scene from yesteryear. Essentially, doctors were sifting through binders of patient profiles, evaluating them line-byline, and guessing based on what they read who might be eligible to participate. Not very efficient, right?
As antiquated as that sounds, the approach they were taking is not that far outside the norm – especially in rare disease populations. The stakes are high in clinical trials. They are high for the researchers that have often poured their life’s work into developing a treatment for a particular health challenge. They are high for the pharmaceutical company funding the clinical trial in hopes of advancing a new treatment for a patient community – and, yes, of making a profit in the process. The stakes are especially high for the patients and families full of hope that a new treatment will make a meaningful impact on their lives. In such a high-stakes environment, the “Where’s Waldo?” approach to finding patients no longer works. It is costly, time-consuming and often ineffective. Those are three words you don’t want associated with a clinical trial recruitment effort.
If the current system isn’t working, the question is: what’s the better approach? Social media has emerged as an effective tool for clinical trial recruitment and engagement. It’s long been bandied about as an opportunity, but until recently, most companies have been too skittish to tap into the full array of social media platforms and tools at their disposal.
Online Trends are Converging
Before understanding how social media provides opportunities for clinical trial recruitment, it’s important to understand why. As a culture, our online behavior has moved from one centered on “active intent” to “passive scrolling.” If you spend any time commuting to work via public transportation (or living with teenaged children) this concept is abundantly familiar. The bulk of online activity is spent mindlessly scrolling through feeds. The numbers support this claim. Approximately 33% of time spent online by U.S. consumers is on social media, which comes to around 2 hours and 15 minutes daily, and Facebook has surpassed Google as the number-one traffic driver to news sources .
But it’s not just that people are spending more time scrolling through social media feeds, it’s that they are increasingly also willing to engage with health content. It is this convergence of online browsing behavior and interest in health-related content that is driving interest in utilizing social media for clinical trial recruitment.
Engaging the Right Audience
As illustrated in the anecdote to start this article, one major challenge in clinical trials is finding the right patients to participate. There are several factors at play and these can vary by disease state. If you are conducting a clinical trial in a therapeutic area that already has a high standard of care, convincing patients to try a clinical trial may be a hard sell. If you are dealing with a more rare or serious condition, the challenge is finding patients in the first place. While all social media platforms have potential for clinical trial recruitment, Facebook is currently doing the most to work with the healthcare industry.
Facebook is expected to have slightly more than 207 million Americans on the platform by the end of 2018 . While significant reach is important, clinical trial recruiting is a little bit like finding the proverbial needle in the haystack – and 207 million is a pretty big haystack. Facebook and other social media platforms offer the ability to target people very specifically based on a variety of factors. For example, if you were running a trial for metastatic melanoma, you could design your promotional efforts on Facebook around not only demographic data but also content interests and geography. Many approaches to patient targeting rely more heavily on demographic information and lack the specificity of what people have indicated they find interesting through their online behavior. Using social media platforms, you can ensure you are reaching people in the right age/gender makeup that are also interested in content related to your clinical trial focus. In the example of metastatic melanoma, you could target people who are following the Melanoma Research Foundation or other prominent groups. It is important to note, Facebook (and other social media platforms), prohibit you for marketing to someone just because they have a health condition. This approach allows you reach people you know have expressed an interest in this type of content but have not expressly indicated they have a certain condition. On top of this demographic and interest-level targeting, you could narrow the audience even further by limiting the promotional efforts to people that are within a certain radius of clinical trial sites. With social media, we are able to focus promotional efforts on the right audience in the right location. That’s a far cry from other patient recruitment tactics that either rely on going as broad as possible (through radio or TV) or very manual efforts – neither of which is resource - efficient.
Fewer Bulletins, More Creative
Finding the right patient is only half the battle – capturing their attention is the other half. There is more content flowing across more channels than ever before. The result is an increasingly high signal-to-noise ratio that is eroding attention spans and making it difficult to break through. The shelf life of a tweet is thought to be around 18 minutes and the shelf life of a Facebook post is thought to be around 5 hours . For clinical trial recruiting, this environment places a premium on content that is relevant and actionable. Relevance relies on the audience targeting discussed above. This enables you to get the content to the right person at the right time, but you still need to be delivering content that is actionable and engaging. You are delivering content to a person that is passively scrolling through social media, almost certainly on their mobile device. The content that accompanies a clinical trial recruiting effort needs to jolt the user to attention. Clinical trial recruiting materials tend to look more like bulletins than attention-grabbing creative. In a social media environment where time is scarce and content is abundant, this approach won’t suffice. As a starting point, pharmaceutical companies need to think of the creative for their clinical trial recruiting efforts in the same way they would a traditional DTC marketing effort.
Once you’ve grabbed the user’s attention, you want them to be able to do something with that content. Potential clinical trial participants are often at a sensitive moment in their lives. They are likely struggling with their illness and in search of new approaches to treatment. The worst thing a company can do is offer content that does not make it easy to achieve that goal. Social media platforms have a number of promotional products that are well-suited for clinical trial recruiting efforts. For example, Facebook has a “click-to-call” advertisement function that can provide information about a relevant clinical trial and, when a person clicks on the ad, prompt them to call the clinical trial site closest to them. In addition, the ad can be “dayparted,” meaning that it will be viewed only during hours when someone is available to answer the phone at the clinical trial site. The advertisement becomes relevant and also immediately actionable. There is no need to get up from the couch to grab a pen or pull over to write down a number. Many social media platforms also have "lead-generation" ads. These are typically used to get people to opt-in to a customer relationship management (CRM) program but can be used for clinical trial recruitment as well. These ads enable the user to easily populate certain key information in pre-determined fields right through the social media platform they are currently using. This keeps the barrier-to-entry low for requesting information.
Don’t Forget HCPs
Clinical trial recruiting efforts mostly focus on the patients. Enrolling the right patient into the right trial at the right time is the priority. However, healthcare professionals (HCPs) have a key role to play in the process as well and they, too, can be reached through social media. During a clinical trial recruiting effort, it’s important to remember that people are very likely to ask their physician about any clinical trial they are considering. They are going to weigh the benefits of the trial against their current treatment regimen and rely on their doctor to guide them in the right decision. This type of conversation only works when the doctor is aware of the clinical trial, who might benefit and which patients are eligible based on the study design. Too often we overlook the HCP’s role in the conversation and create a scenario where patients are asking their HCPs for guidance on a trial they know very little about.
There’s an obvious fact that seems to be a little-known-secret: doctors are people, too. Doctors are active on social media just like the rest of us, and there is an opportunity to extend clinical trial recruiting efforts to them over these platforms. In much the same way you can reach patients, you can reach physicians through social media to raise awareness of a clinical trial, its objective and its patient eligibility criteria. This will help to arm physicians with the right information if a patient comes into their office asking for information about a specific study. Just as in the case of patients, this information can be targeted by specialty and by demographic so that you are only reaching doctors who are treating patients with a specific condition in proximity to a primary clinical trial site. This type of surround-sound approach is important to ensuring a productive conversation the first time a patient expresses interest. It helps to cut down on the period of time required for information gathering, ultimately shortening the clinical trial timeline.
Right Person, Right Content, Right Time
At the end of the day, clinical trial recruiting has always been about finding the right person for the right clinical trial at the right time. It’s a costly endeavor where each day it takes to find these patients adds money, uncertainty and complexity. Previously, finding patients required a combination of old fashioned legwork, broad awareness and luck. As new tools have emerged, social media can help reduce those timelines, limit clinical trial delays due to recruitment problems and minimize the costs of locating patients. Success today requires a rethinking of current recruitment tactics. This shift requires a willingness to embrace more dynamic creative approaches and a desire to be nimble enough so patients can act immediately on what captures their interest. Many companies are starting to conduct their recruiting efforts using the tools that social media makes available. Over time, this trend will only grow in importance as its share in the overall mix of recruitment tactics increases.
Finding the right patient for a clinical trial recruiting can sometimes feel a bit like stumbling around for a light switch in the dark. You know it’s there right at the end of your reach but you can’t quite put your finger on it at the first try. Social media allows you to shine a little light on the process and get to the right patient, with the right content, at the right time.
References
- https://blog.globalwebindex.net/chart-of-the-day/social-media-captures-30-of-onlinetime/
- http://fortune.com/2015/08/18/facebook-google/
- Cordos AA, Bolboaca SD, Drugan C. Social media usage for patients and healthcare consumers: a literature review. Publications. 2017;5:9.
- https://www.statista.com/statistics/398136/us-facebook-user-age-groups/
- https://socialmediaonlineclasses.com/21-ways-to-extend-the-life-of-your-contentinfographic
Chris Iafolla is Head of the digital and social strategy group for Syneos Health Communications. In this role, Chris shapes and guides the social and digital offerings across clients to provide effective, valuable and compliant strategies for the highly regulated healthcare industry. He serves as a senior strategic counselor to clients adopting and executing digital or social marketing strategies. Not just a strategist, Chris works closely with his clients to execute full-scale social media or digital projects from the idea phase all the way through launch and beyond.