Optimizing SMS: The next, text thing in clinical trial communications

If the clinical trial you’re managing is starting to feel like herding cats, you’re not alone.

The challenges of clinical trials start with their recruitment difficulties, proceed through their regulatory restrictions and end with their high rate of drop-outs, even after all else seems to be falling into place.

One effective and low-cost tool in recent years has been the ability to use text messaging for recruitment, retention and reporting for such trials. That success is not so surprising when considering texts produce average 98 percent open rates and 45 percent response rates, compared to emails holding medical, dental or healthcare info that are only opened some 23 percent of the time.

“Texting may be a more scalable solution than other interventions such as apps that require a certain kind of device and software,” adds Marcia Frellick on Medscape.org. “And the technology is well established and can be used on any mobile phone, which most people worldwide have. This technology is increasingly used by people from all socioeconomic classes, age groups and continents."

Consider how your organization might optimize text messaging for the following trial purposes:

  • Recruitment: Some 4.8 billion people worldwide are slated to be using mobile phones by next year, making texting convenient, fast and highly accessible. Combined with the strategic placement of call-to-action ads in targeted locations like physician waiting rooms or relevant healthcare websites, the technology can significantly increase trial response rates. And once a candidate texts back answers to a simple questionnaire, he can be on-boarded instantly without the lag time that comes with other mediums.

One text messaging recruitment campaign last year resulted in a 1 percent increase in enrolled research subjects for every 1.5 percent increase in text messages sent. Over eight weeks, the sending of 1,541 text messages resulted in the screening of 795 patients and enrollment of 265 patients. “The minute we sent the texts, we would immediately get a lot of calls,” reports Mazen Zari of participating organization Johnson County Clin-Trials. “(We got) five times the response compared to e-mail. We were initially concerned patients weren’t going to find text messaging useful, but on the contrary, patients really liked it.”  

  • Segmentation: Once potential trialists indicate their interest by texting back, customized software can assess their unique profiles and better match them to your needs by eligibility and availability — also using data to predict which ones are likely to drop out.
  • Retention: Because of fear and impatience during the on-boarding process and time lag before the trial, up to two-thirds of trialists who indicate interest often drop out before a trial begins. One study places the cost of trial dropouts at $4,000 per person. And trial costs rise as researchers must recruit larger sample sizes when predicting drop out rates.

Research shows, however, that trialists respond well to the texting of personalized appointment reminders and confirmations, compliance alerts and medication-adherence programs aimed at keeping them engaged in their clinical studies. In one study, such texting doubled the odds of medication adherence for middle-aged people with chronic disease.

Artcraft Health clients often optimize its SMS text-back program to offer similarly valuable information to patients who opt in.

“Researchers could prepare text messages addressing common worries or offering more information about the trial that could be automatically sent to patients who express relevant concerns,” suggests Sharon Housley on Notepage.net. “Additionally, texting is a more immediate, comfortable medium for most than calling or emailing, which may cause more people to voice their concerns to the research team than to quietly drop out.”

  • Reporting: Finally, texting allows for timely and effective follow-up regarding trial results once conclusions have been drawn. A lack of such reporting is frequently mentioned by trialists as a downside of such trials, since many participate with the goal of helping others. The National Institutes of Health published a study this year in which many trialists complained of that lack of closure, though 75 percent felt they should be so informed. “Some patients wish to know their personal results, others want the overall study results and many wish to know both,” the NIH reports. “In addition, patients are keen to receive regular updates on the trial’s progress. Not receiving results may deter patients from participating in future trials.”

Not sure if texting will work for your purposes? You might consider using it for supplementary trial information until you get a handle on how it’s being received across a range of patients. Feedback can help you decide whether to make it your primary communications tool.

Contact Artcraft Health to learn more about our SMS text-back program allowing patients targeted access to relevant clinical trial or brand information.

BlogLindsey Kuhl