Patient enrollment and retention challenges in clinical trials

Patient retention in clinical trials in key for its successful completion and strength of the results. According to United BioSource, enrollment and retention inefficiencies are the principal causes of delays on different drug development programs, costing the sponsors from 600 thousand to 8 million dollars in revenue (Industry Standard Research). Also, 85% of trials fail to enroll enough patients and there is around a 30% dropout rage in average. This is why Sponsors and CROs are always following up closely with the sites to ensure adequate patient enrollment and retention strategies.

Some of the most common enrollment and retention challenges that we have had at Althian, and that are about the same in other sites, are the following:

  • Costs of traveling to the site. It is very common to have foreign patients or patients that live very far from the site. Sponsors and CROs should be aware that a traveling fee would be quite helpful in most of the cases because it would help the patient cover his or her traveling expenses, such as, gasoline, bus tickets, taxis, among others. Ensuring a thorough review of the budget allows us to estimate the best fee for traveling expenses and ask for it to the Sponsor, making them aware of the situation and that this kind of reimbursement is helpful in the enrollment and retention of the patients.


  • Long-term follow-ups. It is very common nowadays to have studies that require very long-term follow-ups. These could last years and years… It is important to develop some fun and creative strategies to still be in touch with patients without having them become uninterested anymore. For example, at Althian we have implemented meetings with patients at restaurants for having breakfast together. This strategy has been helpful because patients get to know each other and they get to know the staff better. We have shared good moments with this kind of reunions. It is important to say that the meetings with patients at restaurants are always reviewed by an Ethics Committee before taking place.


  • Access to different medical procedure facilities. We understand that each protocol has different requirements and that different medical procedures are needed to be done. They sometimes have to be performed at facilities outside the site, implying that the patient has to move to other places. Althian is strategically located at the center of the city and nearby a lot of medical centers and hospitals, facilitating the transport of the patient to his or her medical procedures.


Like these challenges, there are many others. It is important that the sites work together with sponsors and CROs to come to an agreement to facilitate the enrollment and retention of patients, ensuring the success of the trial.