‍This article was originally published on pharmaphorum, September 9, 2025.

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The prevailing narrative in clinical research often centres on patient recruitment as primarily an identification challenge that simply requires finding individuals who meet specific study criteria. With electronic health records (EHRs), digital targeting tools, and expansive patient databases widely available, identifying potential participants has never been easier – but this is generally not where clinical trials falter.

More than 80% of clinical trials in the US fail to achieve targeted patient enrolment, according to a 2023 observational study examining recruitment and retention barriers at a private research site. The real challenge is not identifying potential candidates, but converting them into active participants and retaining them – an effort often hindered by complex eligibility criteria, confusing enrolment procedures, ineffective communication, mistrust, and burdensome participation requirements. This often leads trial candidates who could see significant health benefits from participation to disengage before enrolment. The previous study also reveals that more than 30% of clinical trial study participants in the US discontinue participation prior to the trial’s completion.

Researchers must therefore rethink patient recruitment, shifting their perspective to those of marketers optimising a complex customer journey. By treating recruitment as a structured funnel – from initial patient awareness through sustained engagement and participation – researchers can optimise each step to minimise participant dropout.

Transparency is a must

Joining a clinical trial is much like “buying” a high-value/high-risk product and it is critically important for patients to understand exactly what they are signing up for prior to their participation. Electing to join a clinical trial is more than just agreeing to take a study drug or use an investigational device for a specific duration – it’s a time commitment. This includes the time it takes to complete trial activities or drive to a site for in-person visits, as well as any time taken from work and everyday life. Enrolling a patient in a clinical trial without fully explaining their involvement is like selling someone a car without disclosing ongoing maintenance requirements and additional fees at the time of purchase: it sets the stage for frustration, mistrust, and early dropout. These obligations should therefore be made very apparent before a patient spends the time going through the steps of study prequalification.

Complex or unclear enrolment and study procedures can also result in participant abandonment. To mitigate this, researchers must prioritise transparency from the outset by clearly communicating all requirements – such as time commitments, study procedures, and potential risks – across all patient-facing materials like the trial website and flyers.

Leveraging known marketing practices to reach a broader audience

A comprehensive, omnichannel communication strategy tailored specifically to target populations further strengthens recruitment efforts. Effectively utilising social media and paid search ads, as well as building strong relations to advocacy groups and community support networks, can significantly help in reaching demographically diverse patient populations.

Personalisation throughout the enrolment funnel

In marketing, tailored messaging and support are utilised from the very first touchpoint a customer has with a product. This should also be standard practice in clinical research – where trial candidates receive the information they care about most early in the recruitment process to boost participant enrolment, minimise screen failure, and prevent dropout down the line. From the very beginning, this personalisation includes developing advertising materials that highlight what is important to these patient populations, and sometimes tailoring these materials even further to engage distinct patient groups. It’s also imperative that all sources of trial information are readily available in the language(s) that may be spoken in the target patient population.

From enrolment on, it's essential to maintain consistent, supportive contact with participants – whether through email or text reminders about trial activities or personalised phone calls to address questions and offer assistance. Sustained, personalised engagement not only enhances the participant’s experience, but also improves retention throughout the study.

Advertising solutions to common logistical barriers to participation

Transportation, childcare arrangements, scheduling conflicts, and other logistical barriers greatly impact a patient’s decision to engage in a study. These concerns are particularly pronounced in underserved populations. In addition, people ultimately value convenience and minimal disruption to their daily lives. With that, research teams must tackle these challenges with a solution-oriented mindset.

For example, if a trial is decentralised, this should be made clear in patient advertising materials, highlighting the ability to contribute to important medical research at home. It is also critical to showcase elements like compensation for travel, time off work, and childcare for in-person study requirements. This way, potentially eligible individuals have all the information they need to make an informed decision on whether or not to “buy into” a clinical trial.

The need for digital tools and decentralisation

Capitalising on decentralised or digital recruitment approaches promotes trial accessibility and diversity among participants, enabling faster timelines and enrollment of individuals that accurately reflect real-world patient populations.

Decentralisation and digitisation reduce friction throughout the enrolment process. Organising all relevant clinical trial information within a dedicated website makes it easy for candidates to access and reference key details. Web-based platforms can also be used to streamline pre-screening activities and visit scheduling, making the path to participation less time-consuming and more intuitive.

Researchers need to redefine the way they approach recruitment by looking at the participant journey as a streamlined, patient-centred experience that mirrors effective customer acquisition and onboarding strategies seen in other industries. By adopting sophisticated strategies such as transparent communication, patient-focused advertising and outreach, and the use of digital tools, they can enrol high-quality participants more efficiently and accelerate the clinical development of much-needed interventions. This not only speeds up enrolment, but also improves retention, ultimately driving faster medical breakthroughs and delivering better outcomes for patients.