Recruiting participants for clinical studies is widely acknowledged as a critical bottleneck for trial success; both in terms of timelines and scientific quality.
However, one recent update, by Servier, reported that 86 % of international trials fail to meet their recruitment target within the original timeframe. A systematic review found that only approximately one-third of all trials recruit participants as planned. These data lay bare a persistent problem: the old methods aren’t delivering, and the cost of delay is large.
What’s going wrong: recruitment in 2025
Outdated approaches and mismatched expectations
Traditional recruitment models emphasize site referrals, physician outreach, and general advertising (flyers, websites, trial registries). These methods assume patient motivations align simply with “access to new treatment” or “trial participation benefit”. In reality:
Timelines are tighter. Trials are under pressure to launch faster and meet enrolment targets earlier.
Budgets are constrained. Sponsors and sites face cost-pressures, meaning less room for extended recruitment campaigns.
Patients’ wants are evolving. People expect transparency, convenience, understandable information, minimal burden, and sometimes digital-first engagement.
Operational and design constraints
Key barriers from studies include: overly narrow eligibility criteria, high participant burden, under-trained recruiting teams, and unrealistic feasibility projections. In rare disease contexts, for example, limited patient populations and dispersed geography make recruitment especially tough.
The people factor missing
Despite the term “participant” being used widely, many trials treat patients primarily as data sources rather than people with preferences, constraints, and histories.
Communication often remains too technical, burdensome visit schedules too heavy, and the trial experience too opaque. The result: eligible patients don’t sign up, drop-out increases, enrolment slows and diversity suffers.
Why this matters
Delays in recruitment translate into longer timelines, higher costs, and eroded scientific value. One review estimated that slow recruitment is one of the key contributors to trial delays and eventual increased cost of drug development. For sites and sponsors alike, missing enrolment targets means wasted start-up investment, extended staff allocations, lost opportunity. For patients it means slower access to new therapies. For the ecosystem it means less representativeness and weaker evidence.
People-centric solutions: shifting the mindset and the method
Shift from “recruitment” to “engagement”
Viewed through a people lens, steps matter: clear, concise communication; convenience for patients and carers; coordinating with patients’ lives rather than forcing them to accommodate the trial.
Designing protocols and recruitment campaigns with the patient journey in mind is critical.
Simplify design, lower the burden
Revisiting inclusion/exclusion criteria, reducing visit frequency, offering remote or home-based assessments, using digital tools for consent, screening and monitoring. All contribute to lowering friction.
Studies show that digital platforms and e-recruitment approaches can optimize recruitment when used well.
Site partnership and community orientation
Sites must move beyond passive referral roles to active engagement: building trust with patient communities, collaborating with patient advocacy groups, offering transparency on what participation means.
Diversity, equity and access are increasingly strategic imperatives: placing sites and trials in alignment with patient demographics and preferences (location, language, culture) pays off.
Better information and communication: from dense protocol to plain speak
For many potential participants, the first encounter is a website or flyer that lists burdensome visits, technical jargon, vague benefits. The result is confusion or drop-off. That is even before they get to the details and informed consent (too often ending up being widely uninformed consent for lack of understanding of half the lengthy content).
This is how Clinials (not Clinicals) was born, to solve this problem and bring people back into the clinical trial conversation; whether participants or clinical research professionals.
If we shift to clear, plain-language communication that describes what participation actually means, in terms of time commitments, likely benefits, risks, follow-up, and more, engagement improves.
Example: the heavy-friction task of screening and consent
Consider a mid-sized site launching a Phase III study. The coordinator receives a 125-page protocol, plus amendments, visit calendars, tests, and recruitment materials. They must screen dozens of potential patients, explain the study, handle lengthy consent forms, schedule multiple site visits, monitor follow-up calls.
Many patients decline once they see the number of visits, or drop out when lifestyle interference becomes clear. This costs the site time, reduces enrolment velocity and increases attrition.
If instead the recruitment process re-centers on the person: a brief plain-language consent summary, an online pre-screening questionnaire, remote options for visits or some assessments, clear expectations of time and travel offered upfront, then the (many) barriers to participation drop.
A practical path forward
For sponsors, CROs and sites:
Design around the patient rather than retrofit them into a cumbersome protocol. You need them as much, if not more, than they do need you.
Measure recruitment feasibility early: realistic timelines, site capacity, patient pool, travel/distance pain.
Communicate in plain language, minimize jargon, provide transparency.
Use digital tools wisely: e-recruitment platforms, online consent, home visits, remote monitoring.
Build site/community partnerships: patient advocacy groups, local physician engagement, culturally relevant outreach.
The world of clinical trials needs more than faster drugs. It needs better access, better people-experience, and better data. Recruitment isn’t simply a box to tick; it’s fundamentally a human conversation.
When we restore the “people” into “participant”, trials become faster, fairer, and more effective.
Patient information sheet, protocol-to-marketing content, plain language synopsis, and more… . These are documents you can draft near instantly, from a protocol, through Clinials, for $145. Start now.
