Management of any large corporation will tell you that finding good, loyal talent is hard.
A key determinant of the success of a clinical trial is the recruitment and retention of a study population of an adequate sample size.
Low rates of recruitment and retention have a number of negative implications, such as longer durations of the clinical trial, which may lower staff and participant morale; a costlier clinical trial, since extra resources may need to be dedicated to the recruitment effort; and less statistical power for both the study and the validity of the results.
In some cases, inadequate accrual of subjects may result in the termination of the trial. These barriers are already well recognized in the literature. The aim of this article is to examine if the identified barriers are in reality what is encountered by those involved in clinical trials today.
Qualitative data collection Data was obtained on the barriers to recruitment and retention by carrying out in-depth semistructured interviews with a variety of professionals, employed in the United Kingdom, involved in recruitment to clinical trials, both nationally and internationally.
A total of 16 professionals were interviewed, including investigators, representatives from pharmaceutical companies, and representatives from contract research organizations.
For practical reasons, the qualitative data collection for this study was limited to data collection from professionals in the United Kingdom who are involved in subject recruitment. Seeking the opinion of study subjects was beyond the scope of this study and would necessitate a further study.
Despite the small sample size used and the limited range of professionals interviewed, this study yielded some interesting observations.
The sidebar below lists the barriers found in the literature. While this research showed a strong consistency between the literature and the practical experience of those professionals interviewed, a number of enlightening differences between the accepted barriers and the actual barriers encountered in practice today were identified.
Interview respondents identified the same four broad categories of barrier to recruitment and retention as identified in the literature. Each of the key areas identified is discussed below. Interviewees identified many similar subject-related barriers to recruitment and retention as has been noted in the literature.
However, some important differences were also noted. According to the literature, long waiting times associated with clinic visits and inconvenient scheduling of appointments are barriers to recruitment and retention. Secondly, the literature reports that subjects often fail to enter or complete clinical trials as they dislike the uncertainty associated with the trial, and in many cases prefer the doctor to make the decision about their treatment.
It may also reflect the growing knowledge among the public of medical-related matters perhaps as a result of people having greater access to information available on the Internet coupled with their concerns about risk.
However, public concerns about risk do not appear to conform to scientific or technical measures of risk, with an extensive body of literature having been written on this topic.
A useful overview is provided by Slovic. Interviewees reported that subjects who have unrealistic expectations of the clinical trial may be reluctant to complete the study protocol. Such expectations could imply a problem with the informed consent process, with details of the requirements associated with trial participation being poorly communicated to subjects.
This may result in reduced retention, with subjects dropping out prior to trial completion. These have not been conclusively recognized as barriers in the literature.
Interviewees also noted that people are tending to change jobs more frequently and are moving to new locations to take up these jobs. Moving out of the area is an increasing potential barrier to subjects completing trial protocols.
This has not been widely reported in the literature, but is likely to become an issue if such trends continue within the work force.
Despite investigators agreeing to recruit subjects to a clinical trial, many factors related to the trial investigator may prevent them recruiting adequate subject numbers. The main barriers identified in the literature may be divided into logistical factors and personal factors.
The recruitment and retention barriers identified in the literature review and by those interviewed were broadly consistent, but as with the subject-related barriers, some revealing differences were also noted.
An inability of the recruiting physicians to integrate their roles as caregivers with that of scientists is identified in the literature as a barrier to recruitment and retention. Many factors reported by those interviewed as being investigator-related barriers to recruitment and retention were not widely cited in the literature.
It may also be a reflection of research-focused clinicians becoming involved in too many clinical trials. This could reflect a poor choice of investigator to undertake the study, and could also imply poor communication between the sponsor company and the investigator as to the amount of work actually involved in the trial.
It could also imply that proper feasibility surveys are not being undertaken prior to study commencement. The correct choice of study site by those organizing a clinical trial is critical to the success of the clinical trial.
A proper feasibility survey must be undertaken at an early stage in the study site selection process to ensure that the clinical trial can be conducted at the site of choice.
This survey will gather data on the availability of potential study subjects who meet the study entry criteria and the likely recruitment rate, as well as data on competitor studies on-going at the site and any regulatory or ethical issues.
A good feasibility survey will help to ensure the success of recruiting a study population of an adequate sample size.The Significance of Recruitment in an Organization Importance of Recruitment Recruitment is a process if done carefully may clear way for selection, orientation, induction and retention.
Recruitment is the first step of Staffing. The vacancy arise due to promotion, . Study findings identify various factors affecting subject enrollment in today’s clinical trial world.
A key determinant of the success of a clinical trial is the recruitment and retention of a study population of an adequate sample size. The Recruitment Process. We run a transparent recruitment process which varies according to the role and full details for each can be found when you view the job you are applying for.
Recruitment and selection are the most critical and significant human resources functions.
Unless the organization has the best available employees, it will not be able to grow and flourish in the market. The drive and motivational levels of the employees need to be .
Significance of Recruitment and Selection Recruitment and selection process is important for an organization to achieve its goals. When the right people are selected, the employee will produce productive results and stay with the organisation longer hence having a low employee turnover.
Refer to Appendix A Flow Chart. In order to increase efficiency in hiring and retention and to ensure consistency and compliance in the recruitment and selection process, it is recommended the following steps be followed (also refer to Staff Recruitment and Selection Hiring Checklist).Details for each step include the minimum recommended best practice to attract a talented and diverse.