Clinical trials once rarely made the headlines – unless something went drastically wrong – but the past couple of years has changed all that. Amid the full blaze of the pandemic, we saw queues round the block as people volunteered to take part in vaccine clinical trials. The necessity and value of testing new vaccines was particularly evident as the Covid-19 health crisis first gripped nations across the world. And work on vaccines continues – last month, it was announced that Pfizer and BioNTech had started clinical trials for a new Covid vaccine targeting the Omicron variant.
But while rapid development of effective vaccines was achieved – and we are all now enjoying the fruits of that scientific and medical endeavour as restrictions are eased – even with this level of global interest, poor participation continues to be the number one reason for premature discontinuation of clinical trials.
“How healthcare comms can better support clinical trial recruitment.“
Struggling to recruit enough patients to take part in clinical trials besets all areas of medicine. In part, this is because of the shear volume of trials now taking place. Between 2000 and 2020, there was a 1500% increase in yearly registered clinical trials. In addition, the improved understanding of commonalities of medical conditions has increased testing. Drugs that work for one condition can now be tested for others – such as in autoimmune diseases. For all pharmaceutical companies, recruiting enough participants into trials – and faster than their rivals – has become an increasing priority.
So, there is clearly a major role for effective healthcare communications to help recruit people to – and retain people in – clinical trials.
At the heart of the clinical trial recruitment communication challenge is the need to build trust. This is complex; one of the key requirements is that it does not communicate any potential benefit of investigational drugs yet it must be very clear on the risks involved. While the rationale behind this is appropriate, it means encouraging people to take part is an even harder task – there is a potential consequence that it might be holding back science as fewer people are willing to join trials.
Central to any communication is knowing who the audience is – so that the content, message and tone fit their requirements and understanding. And as pharmaceutical companies must produce significant quantities of materials associated with any clinical trial – for doctors, healthcare professionals and patients who might take part – knowing your audience is paramount.
But so much of this material is created with one eye on it achieving ethical approval – ensuring that it is not raising hope nor hiding risk. This is quite a different set of communication needs to helping a patient understand informed consent and the nature of the clinical trial. Writing something that is formal, to impart fair and balanced detail, is not the same as writing something that helps a layperson understand the truth of what they will be involved in.
There are further challenges as the way clinical trials are conducted is changing – technology means more trials can take place remotely. The technology has often led to better efficiency as it removes some logistical barriers – people don’t necessarily have to visit a hospital. But it has also removed some of the human element – that all important human touch as face to face interactions are reduced.
When we are considering informed consent, the forms read like a contract, and that can be terrifying for some people. Someone who may have been willing to take part in a trial, can end up changing their minds as they plough their way through these forms, seeing every risk laid out, however statistically unlikely. But if this stage is done in-person, with a doctor or nurse running through that consent form, they can see the micro expressions on the patient’s face and ensure that the reality of participation is clearly understood. By witnessing someone’s reaction they may be able to uncover a limiting belief – one that upon questioning helps the patient see the benefits of taking part in a clinical trial. If this process is done remotely, on a computer at home – those cues won’t be seen, conversations may not take place and there’s more room for misunderstanding.
Digital has some clear strengths especially in terms of making clinical trials less of an undertaking for patients. It is also great for additional data capture from a learning and scientific perspective. But it ups the stakes for anyone interested in communication.
So how can we build the human touch into the digital experience? One sure-fire way is to share human stories. There is much greater scope for celebrating the stories of people who have been through clinical trials themselves. Is a patient most influenced by hearing a doctor explain what it’s like to take part in a trial, or by a patient who can share their lived-in experience? They don’t have to talk about the risks but they can talk about the experience in broad terms. Introducing emotion is a powerful means of creating a connection.
Communications need to build confidence in clinical trial participation – explain that there are many safety mechanisms in place and run by people who can be trusted and that the technology available can make the process smoother. Making the digital experience more human requires more of a conversation – addressing barriers, resistance and concerns – and then it will feel like a more trustworthy experience.
So, our role as agencies working with pharmaceutical companies is to use our communication skills to build trust – by using patient insights and mirroring their thoughts, concerns and feelings. It is possible to build very powerful connections. If a patient recognises themselves and their experiences in the communication, they are more likely to think the drug manufacturer understands what they are going through and how their lives are affected. This can cut through the noise and show that they are on the same journey and may reach a better place by working together.