10 Ways to Set Up Your Sites for Recruitment Success

Recruitment is arguably a clinical trial site’s greatest challenge.

Taking the following steps can better support your sites to be more effective in recruiting the necessary patients needed to make your trial a success.

1.  
   Select the right sites
   

   Use all data at your disposal to ensure you choose sites with the right experience, patient population, diversity mix, and timelines. Make sure you spend time on your site qualification/feasibility outreach to ensure they treat the relevant patient population.

   It is also important to find out how to avoid the rate-limiting processes that delay site opening (e.g., contracts, EC submissions, etc.). Finally, do not hesitate to use unknown sites with less experience. Often these sites have the motivation, patient population, and capacity to really deliver.

2. Think about recruitment at the time of protocol creation
   

   From the moment you begin to create your protocol, you will want to make sure you resolve as many potential issues with recruitment as you can before they arise. Ask your team: Are your eligibility criteria viable? Are the visit schedule and/or procedures burdensome? Is there a robust feedback process by which sites can communicate difficulties with recruitment and/or I/E criteria?

3. Involve key opinion leaders (KOLs) and sites early in protocol development
   

   It is important to get KOLs and sites involved in planning early in the process of developing your protocol. This will help you avoid protocol amendments down the line.

4.  
   Choose sites with experience in your preferred technology
   

   If a site manages several trials and uses multiple new systems to navigate, low bandwidth can slow patient recruitment. Make sure you discuss the technology the sites are accustomed to using (e.g., EDC, ePRO, IVRS, etc.) before you reach an agreement. And once you have selected your site partner, try to offer enough support in your technology for ease of use.

5. Provide sites with the high-quality materials they need for outreach at the start
   

   From the beginning, make sure you discuss what types of patient outreach the sites will be conducting (e.g., print materials, multiple social media/digital options, etc.). That way, you can tailor materials to suit each form of outreach. It is also helpful to make non-English materials available at the start to help ensure diverse recruitment.

   Keep in mind that sites know what works best with their communities and may need to supplement with additional materials to ensure the study is a success.

6. Offer sites enrollment optimization support services for any external recruitment campaigns
   

   These are typically part of patient recruitment vendors’ solutions when delivering referrals. For example, you will want to provide a defined process for sites processing prescreened, qualified referrals received by recruitment campaigns. You will also need to offer medical records retrieval services to support additional qualification review for externally sourced, prescreened referrals.

7. Train sites on processes/technologies for receiving prequalified referrals from external patient recruitment campaigns
   

   Collaborate with sites to identify any referral pathways that can be supported through technology/sponsor-partner support.

8. Ensure timely patient payments
   

   This is vital, as sites are the ones that must field these complaints, which adds to their burden. Being late with payments can also affect patient retention.

9. Consider involving patient advocacy groups with established site relationships
   

   Ask sites if they work with patient advocacy groups you could jointly contact to inform their patients of potential clinical trial opportunities.

10. Remunerate sites for external patient recruitment campaigns
    

    Sponsor/CRO-site contracts typically do not cover the costs associated with additional staff time required to process externally sourced referrals, which puts further economic stress on sites. So, make sure to pay sites for time/resources dedicated to contacting, processing, and evaluating any prequalified referrals received from external patient recruitment campaigns.

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