Facebook advertising in clinical trial patient recruitment

With the continuing growth in both medical device and bio-technology solutions, successful conduct of any clinical trial is crucially important for future commercialization. However, it has been reported that nearly 70% of randomized clinical trials have either required an extension to the patient recruitment period or have failed to meet their recruitment targets. In addition, due to poor patient recruitment strategies and patient retention, it has been reported that less than 10% of clinical trials are completed on time.

Quality , quantity or both?

Recruiting higher numbers of quality patients is a first step and provides a solid foundation for an effective and statistically significant trial. It is also one of the points that can be overlooked or neglected in the trial design phase, especially for start-ups looking for quick market entry and/or product validation.

Traditional trial recruitment methods, such as print (brochures, flyers, billboard, newspaper, magazine etc) and broadcast (TV and radio), are increasingly proving to be both costly and inefficient, while online methods of advertising are increasing in popularity. In particular, Facebook’s social media advertising platform has shown to be productive in regards to trial recruitment.

In the United States, about 74% of women and 62% of men are Facebook users, allowing advert campaigns to be conducted on a nationwide basis. The ability to target trial candidates based on certain demographics increases the value of each potential candidate, as basic inclusion/exclusion criteria can be built in to the target audience. This allows for efficient ad-campaigns and target audiences that can be further enhanced by defining catchment areas for campaigns that are dedicated to recruiting for specific research sites.

Facebook advertising: disruptor to mainstream?

A review of patient recruiting in 2017 found that a total of only 35 trials had implemented Facebook as a tool for patient recruitment. Facebook was initially viewed as a disruptor to the patient recruiting market, it has since proven to be an efficient strategy, especially true when compared to traditional recruitment methods. There are specific outcome measures that have been used when analyzing the value of different methods in patient recruiting, which include:

1. Impressions – The number of times the ad was displayed
2. Cost per Mille(CPM) – The cost per 1000 impressions
3. Click Through Rate(CTR) – Amount of interest measured by dividing the number of clicks on the ad by the total number of impressions
4. Cost per Click – Participants re-directed to an external landing page measured by the total cost of the campaign divided by the number of study site unique link clicks
5. Cost per Consent – Cost for one individual completing enrollment at a research site
6. Cost per Randomization – An estimated cost for one individual reaching the randomization stage of the trial.

Using these outcome methods, Facebook can be compared to using traditional recruitment methods in a quantifiable manner. A 2016 review of using Facebook for recruitment purposes in the health and psychosocial research fields showed an average cost per participant at US$17.48 (Standard Deviation US$ 23.06; Range US $1.36 – $110), although not all of these studies were defined as RCT’s.

Additionally, a study involving an extremely brief intervention for young veteran drinkers was able to recruit 793 participants in a matter of 7 days. In this specific example, the cost per participant was under US $5 and 4.4% of advertisement clicks were converted into study participants. Finally, an Australian study for smoking cessation resulted in lower costs to obtain a screened respondent (AUS $22.73 compared to $29.35) and cost to obtain an eligible respondent (AUS $37.56 compared to $44.77) when comparing Facebook to traditional methods.

Managing the recruitment process

While research begins to point to Facebook as a viable option for patient recruitment in clinical trials, the following additional factors are important components of the recruitment process and crucial in controlling cost, quality and number of applicants:

1. Effective preliminary pre-screening and secondary pre-screening.
2. Ongoing optimization of the campaign
3. How to educate the viewer / applicant during the process

As each clinical trial differs it is important to decide on, and implement a customized campaign that fits with the overall goals of the study.

Sources

Facebook advertising for participant recruitment into a blood pressure clinical trial

Using Facebook for Large-Scale Online Randomized Clinical Trial Recruitment: Effective Advertising Strategies

What Influences Recruitment to Randomised Controlled Trials? A Review of Trials Funded by Two UK Funding Agencies​

Facebook ads to the rescue? Recruiting a hard to reach population into an Internet-based behavioral health intervention trial

Reaching Concerned Partners of Heavy Drinking Service Members and Veterans through Facebook

Recruiting for health, medical or psychosocial research using Facebook: Systematic review

The Effectiveness Of Social Media (Facebook) Compared With More Traditional Advertising Methods for Recruiting Eligible Participants To Health Research Studies: A Randomized, Controlled Clinical Trial