JMIR Publications

ABSTRACT

Background:

Recruitment for clinical trials continues to be a challenge as patient recruitment is the single biggest cause of trial delays. Around 80% of trials fail to meet initial enrollment target and timeline, and these delays can result in up to as much as $8 million per day in lost revenue for drug developing companies.

Objective:

To conduct a systematic review and meta analysis examining the effectiveness of online recruitment of participants for clinical trials compared with traditional in-clinic / offline recruitment methods.

Methods:

Data on recruitment rates (the average number of patients enrolled in the study per month and per day of active recruitment) and conversion rates (the percentage of participants screened who proceed to enroll into the clinical trial) as well as study characteristics and patient demographics were collected from included studies. Differences in online and offline recruitment rates and conversion rates were examined using random effects models. Further, non-parametric paired Wilcoxon test was used for additional analysis on cost-effectiveness of online patient recruitment. All data analysis was conducted in R-Language, and P<.05 was considered significant.

Results:

: In total 3,861 articles were screened for inclusion. Of these, 61 studies were included in the review and 23 of these were further included in the meta analyses. We found online recruitment to be significantly more effective with respect to the recruitment rate for active days of recruitment, where 100% (7/7) of the studies included had a better online recruitment rate compared to offline (IRR 4.17, P = .038). When examining the entire recruitment period in months, however, we found that 52% (12/23) of the studies had a better online compared to offline recruitment rate (IRR 1.11, P = 0.71). For cost-effectiveness we found that online recruitment had a significantly lower cost per enrollee compared to offline recruitment (72 USD vs. 199 USD, P = .04). Finally, we found that 69% of studies had significantly better offline compared to online conversion rates (RR 0.8, P = .02).

Conclusions:

Targeting potential participants using online remedies, is an effective tool for patient recruitment for clinical research. Online recruitment was both superior in regards to time-efficiency and cost-effectiveness compared to offline recruitment strategies. Offline recruitment still outperforms online strategies with respect to conversion rate. Clinical Trial: Not registered.