Recruiting trial participants online
A clinical trial can be advertised online to people who are not looking for one, and found online by people who are. Trials struggle to enrol, and a social media campaign for one depends on the platform and its population, what the advertisement says, review-board approval, the prescreener the advertisement leads to and the control of comments. A landing page for the trial and a public map of trials help a reader find a trial and decide whether to join.
The recruitment problem
A recruitment vendor holds that finding, engaging and activating patients for enrolment is a key success factor for every biopharmaceutical company developing new treatments, and that many companies struggle to find the participants they need within the timeline, which adds development cost and, more importantly, delays the treatments themselves.
In 2017, more than 6000 trials involving more than a million patients were running in the United States on any given day. A trial cost $13 million in total at phase 2 and $20 million at phase 3, and the industry spent more than $5.9 billion a year on patient recruitment services. Roughly 80% of trials failed to meet enrolment timelines, about 30% of phase 3 terminations were due to enrolment difficulties, and 15% to 20% of sites never enrolled a single patient. Other research suggested that 80% of US trials were delayed by at least a month because of low enrolment.
A figure attributed to a scientific publisher puts the share of clinical trials that struggle with enrolment at over 80%, which causes costly delays and requires new research sites to be added. In Eastern Europe, surveys show that a significant percentage of the population has never heard of clinical trials, and that others lack essential knowledge of the trial process and of how to take part.
Why social media suits recruitment
The vendor holds that social media marketing can help accelerate enrolment, which ultimately can help bring medicines to patients earlier, and reports that its own digital process has accelerated recruitment for dozens of trials of new medicines for serious diseases. Recruitment through social media was on the rise, and in one study 9 of 14 medical research companies planned to use it to boost enrolment.
The average person checked social media 17 times a day, nearly once an hour, and sometimes sought information about and support for their disease there. The vendor's campaigns aim to use one of those check-ins to deliver clear, actionable information about a relevant trial. The vendor gives five reasons why the channel suits trials:
- Targeting. Social media give a level of efficient targeting rarely accomplished by any other media: a television, bench or bus-stop advertisement can never guarantee a demographic, whereas a Facebook advertisement for a uterine fibroids trial can be limited to women of childbearing age, and further to those whose behaviour on the platform shows an interest in the condition.
- Measurability. The number of users who view an advertisement, click on it and take an action on the prescreening website can be counted, and a potential participant followed through to screening and enrolment.
- Actionable education. Patients report the frustration of finding a trial and having no button to press to put themselves forward. The vendor's campaigns aim to capitalise on their desire for easy access to the right information and for the ability to act, and an advertisement leading to a prescreener gives them a definitive step towards being considered.
- Demographic. The users of networks such as Facebook usually fall within the population sponsors and researchers look for in participants, and in a trial in breast cancer with a genetic modifier the vendor found the highest engagement on Facebook among women aged 50 and over.
- User disposition. A user need not be looking for a trial to see the advertisement, which appears in the news feed among friends' posts. Waiting for people to search for a trial, or to log in to a disease or patient community, diminishes the chance of finding them, whereas a targeted advertisement meets them on Facebook or Instagram, where they are already logged on and active most days. The vendor counts such advertisements critical to its campaigns' success.
Platforms and their populations
In the vendor's view, four social networks were the most effective marketing platforms for trial recruitment, with these user figures of 2017:
- Facebook, the world's biggest social media platform with more than 2 billion monthly active users, offered several advertising formats including video and pictures, and targeting on prospective patients' behaviours and interests.
- Instagram, with 700 million monthly active users, shared Facebook's targeting and carried pictures with text. Six in ten adults aged 18 to 28 used it, so companies typically advertised trials there in episodic conditions such as acne or chronic ones such as rare genetic disorders, and its demographic targeting was refined and efficient.
- Twitter, with 328 million users, suited communicating with patients, posting corporate updates, raising a facility's visibility and attracting industry leaders, with hashtags to increase referrals and sign-ups.
- Snapchat, launched only in 2011, had a loyal base of 166 million daily users, many of them under 30, and offered Stories for advertising to increase engagement and enrolment.
The advertisement's language
In the vendor's guidance, the advertisement's language should focus on the opportunity to take part in a study of an investigational medicine. It should make no efficacy or tolerability claims about the medicine and contain no pointed language that could make the viewer feel targeted or identified. A good advertisement simply lets the user know that a trial of an investigational treatment for a specific condition is taking place and invites a click to learn more. A campaign needs a strategy, and several options of message and creative to test so that it can be optimised.
The language should also be patient-friendly, because trials are full of technical vocabulary the average person does not understand. The vendor's testing of wording with patients pointed to a sixth-grade reading level as the ideal, and technical words such as "subject" for a participant, or "double-blind", should be replaced with common words or definitions.
Review-board approval and the prescreener
Institutional review board approval before a campaign is launched to patients is mandatory, and review boards like to see the complete marketing package, including the controls to be applied to any social media campaign.
The advertisement leads to an online prescreener designed for the study. The prescreener should contain only a handful of well-written questions that give a first level of screening against the inclusion and exclusion criteria, and these may ask whether the person has been diagnosed with the condition, has undergone certain confirmatory tests and is willing to take part in a trial. It should also ask the person to opt in legally to communications about considering enrolment. Those who sign up are followed up by email, text message or telephone to continue prescreening or to schedule a screening visit at the nearest site. In the vendor's process the submissions then go into a patient-led management system of its own, through which a person is followed from the advertisement to screening and enrolment.
Comments on advertisements
Social media advertisements can be shared and commented on, and comments raise compliance issues, because a comment may carry user-generated misinformation that stays attached to the bottom of the advertisement as it is shown to the next user. The vendor suppresses comments on Facebook news-feed advertisements with a tool and disables them on Instagram advertisements before launch, and with that approach every one of its campaigns received review-board approval. Comments should also be monitored for the rare case in which a trial participant reports an adverse event, and if one appears the sponsor's reporting procedure should be followed to begin an investigation.
Results of one campaign
A large global pharmaceutical company enrolling a phase 3 trial in breast cancer with a genetic modifier engaged the vendor to accelerate genetic testing, identification of participants and enrolment, by telling women with breast cancer about the trial and the opportunity to receive genetic testing. The campaign targeted Facebook users who had previously taken actions denoting an interest in breast cancer, A/B tested images, text and targeting, and suppressed all comments on news-feed advertisements. The vendor reports that the campaign accelerated enrolment by three months, which it counts significant when a month of trial operation costs millions of dollars. By the vendor's account, of 9419 US patients who began online prescreening from the advertising, 866 completed it and qualified for follow-up by trial sites, and the sponsor commissioned a repeat for a trial in prostate cancer.
Landing pages
A landing page, a dedicated single-page website, can deliver accessible, patient-centric information about a specific clinical trial alongside the physician referrals and printed materials of traditional recruitment, in the view of writers at a contract research organisation. Its readers are not scientific experts, so clear, accessible language is essential. The writers give these key elements of an effective landing page for trial recruitment:
- Address the pain point the study aims to solve directly, as in "Struggling with insomnia?" or "Are you suffering from constant lower back pain?", acknowledging the reader's unmet need at once.
- Give concise information about the investigational drug and its manufacturer, since mentioning a well-known pharmaceutical company can significantly enhance trust and credibility, and people tend to trust information they are already familiar with.
- Demystify the process in a section on what to expect during the study: each stage, the number of injections, how often the clinic is visited and whether a nurse visits at home, and the length of the observation period, since transparency builds confidence.
- Showcase the contract research organisation's experience and track record, with logos of global pharmaceutical partners, previous successful projects, years in the industry, the number of patients recruited across studies and a map of office locations, which can influence potential participants' decisions.
- List the benefits of taking part, such as free study medication or coverage of travel expenses. Financial compensation is not always the main motivation, especially for those seeking access to innovative treatments, but transparency about costs is essential.
- Post an online eligibility test to get information quickly from a potential candidate, with basic questions such as whether the reader is between 18 and 65 years of age, is experiencing pain and what kind. Commonly, a significant number of those completing it can be identified as potentially eligible and advance to the screening process.
- Answer common concerns and give further details about the study in a section of frequently asked questions.
In the writers' examples, an outline of the study stages covers preliminary screening, injections, observation and monitoring, and doctor consultations, in a study lasting about 15 months under the supervision of the treating physician-investigator. A benefits section has transport to the research centre paid from the study budget, with travel from regional towns to the main regional centre arranged and paid for in full. A section on the investigational product says that the drug had completed a first-in-human trial and preclinical studies in animals "which demonstrated its safety and efficacy".
The page's link can be distributed through pharmacy and clinic websites, medical forums, targeted social media advertisements, patient advocacy groups, online support communities and partnerships with healthcare providers. The writers report that landing pages brought recruitment faster than average enrolment rates in similar studies, better candidate leads, fewer screen failures through better-informed participants, and more engagement throughout the trial. A well-designed page, they hold, lets potential participants weigh their own goals and interests against the trial and its potential benefits.
A public map of trials
By March 2025 clinical trials in the European Union could be looked up on a public map. On 3 March 2025 the European Medicines Agency announced a clinical trial map on the public website of the Clinical Trials Information System (CTIS), built on the public information the system holds and designed to give patients and healthcare professionals real-time information about trials in their area, to increase access to clinical research in the EU. Users could look for ongoing trials by geographic area and medical condition, the search supported queries in lay language and suggested corrections for misspellings, and the results gave investigators' contact details so that members of the public could enquire directly about enrolment. The first version was in English, with other EU languages to be added. The map was an action of the 2025–2026 workplan of the Accelerating Clinical Trials in the EU initiative, answering requests for a simple, patient-friendly dashboard to help stakeholders, particularly patients, locate trials. The agency gave a live demonstration in a public webinar on 7 March 2025, with a recording to follow.