Use of Social Media to Recruit Clinical Trial Participants

Research and innovation are rapidly developing new healthcare tools. However, widespread adoption of contemporary medical technologies and procedures is ultimately dependent upon extensive testing in the form of clinical trials. Clinical trials, as defined by the National Institutes of Health, are studies in which human subjects are divided into experimental groups and given a treatment [1]. As such, each clinical trial necessitates voluntary participation of a large and demographically varied sample of test subjects in order to demonstrate the generalizability as well as efficacy of the procedure in question [1]. This requirement, however, has historically proven difficult to meet – a study performed in 2013 by the Tufts Center for the Study of Drug Development found that 11% of sites fail to enroll even a single patient, while 37% under-enroll [2]. Ultimately, 90% of trials are able to meet baseline recruitment standards – but only if the original testing period is doubled in length [2].  

Furthermore, recruitment generally struggles to reach minority and other underserved populations; for example, according to the Food and Drug Administration’s “Successful Strategies for Engaging Women and Minorities in Clinical Trials,” only 1% of clinical trial participants report Hispanic origins even though 16% of the U.S. population is Hispanic [3]. This trend also applies to sex distribution, with male patients typically being more likely to participate [3].  

These discrepancies in expected and actual patient enrollment rates have led many healthcare groups, both independent and corporate, to reevaluate commonly accepted methodology for recruiting (mail, recommendation from primary healthcare physician, newspaper, billboard, and television advertisements, etc.) [4]. Specifically, the use of social media may prove viable in the evolution of patient recruitment due to the sheer volume of potential candidates accessible as well as the convenience of online platforms. Furthermore, online patient support groups could potentially allow for the stratification of this data, allowing researchers to find target participants more efficiently [5]. 

A recent follow-up report by the Tufts Center found that the industry’s shift towards online recruitment has already shown results, citing that 77% of sampled studies have been able to meet or even precede projected recruitment timelines, marking a significant development since the 2013 study [2], [6]. Dr. Mary Jo Lamberti, an associate research director at the Tufts Center and research assistant professor, attributes this improvement to the incorporation of patient feedback in trial protocol design, data which was gathered through the “increased use of technology solutions and mobile apps” [6]. 

A clinical trial performed by Dr. Julie M. Cowie and Dr. Mark E. Gurney demonstrates a practical application of social media recruitment [4]. The study, which required healthy elderly participants, was unable to meet its participant quota via traditional recruiting methods, so the trial sponsor began advertising the study through Facebook [4]. Following the 8-week advertising period, the results of the campaign proved fruitful: 621 responses were received from the online advertisements alone (as compared to 178 responses received via traditional means), and the clinical trial was able to fulfill its recruitment prerequisite of 45 participants [4].  

Despite this success, the transition to social media-based recruitment still merits further discussion. Of course, the use of social media as a platform for confidential medical information could lead to a string of ethical violations if mismanaged. For example, Merinopoulou et.al. presented a study in 2015 examining over one million posts sampled from prominent United States and United Kingdom social media platforms and found that 0.9% of these randomly sampled posts referenced clinical trials in some capacity [7]. While discussion between participants does not necessarily invalidate the results of a clinical trial, increased use of social media for testing could divulge important trial details (leading to unblinding for potential participants) or lead to the spread of misinformation about studies and their content [7].  

The future of drug development may well be characterized by the use of social media as a database of potential study participants, however, considerable deliberation on the ethics of this transition must first take place in order to safeguard both patient and study confidentiality.  

References  

[1] “NIH’s Definition of a Clinical Trial.” 08-Aug-2017. Available: National Institutes of Health, https://www.nih.gov/ 

[2] Tufts Center for the Study of Drug Development, “New Research from Tufts Center for the Study of Drug Development Characterizes Effectiveness and Variability of Patient Recruitment and Retention Practices,” 15-Jan-2013. Available: https://www.csdd.tufts.edu/csddnews/  

[3] Food and Drug Administration, “Dialogues on Diversifying Clinical Trials.” 22-Sep-2011. Available: https://www.fda.gov/science-research/  

[4] J. Cowie and M. Gurney, “The Use of Facebook Advertising to Recruit Healthy Elderly People for a Clinical Trial: Baseline Metrics,” 06-May-2017. Available: https://www.researchprotocols.org  

[5] Lancet Oncology, “Clinical Research in the Age of Social Media,” vol. 15, (6), pp. 539, 2014. Available: ProQuest, https://search-proquest.com  

[6] Tufts Center for the Study of Drug Development, “Drug Developers Are Making Strides in Streamlining Patient Recruitment and Retention for Clinical Trials, According to Tufts Center for the Study of Drug Development,” 28-Jan-2020. Available: https://www.csdd.tufts.edu/csddnews/  

[7] E. Merinopoulou, C. Chalkiadaki, S. Abogunrin, D. Lambrelli, A. Cox, “Let’s Talk! Is Chatter on Social Media Amongst Participants Compromising Clinical Trials?” 01-Nov-2015. Available: https://www.valueinhealthjournal.com