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Meeting Enrollment Goals in
a Competitive Environment:
Development, Implementation &
Monitoring of Site Patient Recruitment
& Enrollment Plans

Presenter
Jacqueline Zarro, Ph.D.
Vice President
Clinical Project Management - US
Premier Research Group Limited
United States
Disclaimer
• The views and opinions expressed in the following PowerPoint
  slides are those of the individual presenter and should not be
  attributed to Drug Information Association, Inc. (“DIA”), its
  directors, officers, employees, volunteers, members, chapters,
  councils, Special Interest Area Communities or affiliates, or any
  organization with which the presenter is employed or affiliated.

• These PowerPoint slides are the intellectual property of the
  individual presenter and are protected under the copyright laws
  of the United States of America and other countries. Used by
  permission. All rights reserved. Drug Information Association,
  DIA and DIA logo are registered trademarks or trademarks of
  Drug Information Association Inc. All other trademarks are the
  property of their respective owners.


   46th Annual Meeting
   Washington, DC - 2010         2
Topics

• Basis for Meeting Enrollment Goals
  – Foundation and Tools
• Recruitment and Enrollment Plan
  – Site Specific
• Maximize Enrollment
  – Tracking and Additional Tools




  46th Annual Meeting
  Washington, DC - 2010     3
Enrollment Statistics

Statistics show most clinical trial delays are a result
of poor enrollment:
• More than 70% of U.S. and 55% of European clinical sites
  reported delays of more than one month beyond contracted
  enrollment timelines
• Only 7% of U.S. and 18% of European sites reported
  meeting enrollment timelines (U.S. down from 10% in 2005)
• Delays also occurring at high rates in other regions of the
  world

* 2007 CenterWatch Survey Results

    46th Annual Meeting
    Washington, DC - 2010            4
Basis for Meeting Enrollment Goals:
     Foundation to Enrollment Success


                             Regular review            Status updates


                        Roll-out of enrollment plan
                                                       Communication
                        Study enrollment planning


                        Inclusive site qualification
                                                       Feasibility
                         Thorough site feasibility



46th Annual Meeting
Washington, DC - 2010                  5
Basis for Meeting Enrollment Goals:
                   Tools



                                                     Single Site
Feasibility                               Study       Specific
                           Site                                    Enrollment
                                        Enrollment     Study
  Analysis              Qualification                                Target
                                           Plan      Enrollment
                                                        Plan




46th Annual Meeting
Washington, DC - 2010                      6
Recruitment and Enrollment Plan:
Single Site Specific Study Enrollment Plan




 46th Annual Meeting
 Washington, DC - 2010   7
Recruitment and Enrollment:
                 Site Specific Plan Definition

• Template tailored to indication, study design
• Includes recruitment resources / approach
  and targets for enrollment
• Written hard-copy document
• Site specific
• „Agreement‟ signed by site staff



  46th Annual Meeting
  Washington, DC - 2010       8
Recruitment and Enrollment Plan:
            Site Specific Plan Content

• Site‟s:
  – Enrollment target
  – Timeframe
  – Recruitment sources
         • E.g.: database, advertising, referrals, outreach
  – Subject identification activity to date
  – Barriers to recruitment and enrollment



  46th Annual Meeting
  Washington, DC - 2010          9
Recruitment and Enrollment Plan:
       Site Specific Plan Implementation

                                                           Ongoing
                                                         Communication




  Template
                        Tailored to be   Signed by
   developed                                         Review
                         site specific   PI and SC
    by PM




46th Annual Meeting
Washington, DC - 2010                        10
Recruitment and Enrollment Plan:
         Site Specific Plan Implementation
• Sample template plan, tailored by Site



                                           Study
                                           enrollment
                                           expectations




                                           Site
                                           enrollment
                                           expectations




  46th Annual Meeting
  Washington, DC - 2010   11
Recruitment and Enrollment Plan:
         Site Specific Plan Implementation
• Proactive identification of pitfalls
• Signed by PI and Study Coordinator

                          Identification and review of challenges to enrollment
                          • Past study challenges                                 Recruitment
                          • Challenges unique to current protocol                 challenges
                          • Creative approaches to proactively addressing




                                                                                  Site
                                                                                  signatures




  46th Annual Meeting
  Washington, DC - 2010                 12
Maximize Meeting Enrollment Goals:
                                          Tracking
                                               Cumulative Enrollment Graph
                              450
Number of Patients Enrolled




                              400
                              350
                              300
                              250
                              200
                              150
                              100
                              50
                                0




                                        Projected Enrollment per Plan   Actual Patients Enrolled



                       46th Annual Meeting
                       Washington, DC - 2010                    13
Maximize Meeting Enrollment Goals:
              Additional Tools

• Study Coordinator teleconferences
• Outreach
  – Advertising
         • Flyers/brochures in office
  – Local resources
         • Health Fairs
         • Community Groups
  – Hospital / health community newsletters
  – Clinical study postings on websites
  46th Annual Meeting
  Washington, DC - 2010          14
Maximize Meeting Enrollment Goals:
              Additional Tools

• On-going communication
  – Regular site calls (e.g., weekly, bi-weekly)
         • Scripted and non-scripted dialogue
  – Site teleconferences
  – Enrollment metrics
         • Screened, enrolled completers
                – Projected
                – Actual
                – Total active / eligible sites


  46th Annual Meeting
  Washington, DC - 2010                   15
Conclusions

• Proactive approach
  – Thorough site feasibility and qualification
• Enrollment plan
  – Introduction, development of study-specific
    template; implementation of individualized plans
• On-going review of plan and tracking
• Maximize knowledge and creativity
• Contingency planning
  46th Annual Meeting
  Washington, DC - 2010       16

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Meeting Enrollment Goals in a Competitive Environment

  • 1. Meeting Enrollment Goals in a Competitive Environment: Development, Implementation & Monitoring of Site Patient Recruitment & Enrollment Plans Presenter Jacqueline Zarro, Ph.D. Vice President Clinical Project Management - US Premier Research Group Limited United States
  • 2. Disclaimer • The views and opinions expressed in the following PowerPoint slides are those of the individual presenter and should not be attributed to Drug Information Association, Inc. (“DIA”), its directors, officers, employees, volunteers, members, chapters, councils, Special Interest Area Communities or affiliates, or any organization with which the presenter is employed or affiliated. • These PowerPoint slides are the intellectual property of the individual presenter and are protected under the copyright laws of the United States of America and other countries. Used by permission. All rights reserved. Drug Information Association, DIA and DIA logo are registered trademarks or trademarks of Drug Information Association Inc. All other trademarks are the property of their respective owners. 46th Annual Meeting Washington, DC - 2010 2
  • 3. Topics • Basis for Meeting Enrollment Goals – Foundation and Tools • Recruitment and Enrollment Plan – Site Specific • Maximize Enrollment – Tracking and Additional Tools 46th Annual Meeting Washington, DC - 2010 3
  • 4. Enrollment Statistics Statistics show most clinical trial delays are a result of poor enrollment: • More than 70% of U.S. and 55% of European clinical sites reported delays of more than one month beyond contracted enrollment timelines • Only 7% of U.S. and 18% of European sites reported meeting enrollment timelines (U.S. down from 10% in 2005) • Delays also occurring at high rates in other regions of the world * 2007 CenterWatch Survey Results 46th Annual Meeting Washington, DC - 2010 4
  • 5. Basis for Meeting Enrollment Goals: Foundation to Enrollment Success Regular review Status updates Roll-out of enrollment plan Communication Study enrollment planning Inclusive site qualification Feasibility Thorough site feasibility 46th Annual Meeting Washington, DC - 2010 5
  • 6. Basis for Meeting Enrollment Goals: Tools Single Site Feasibility Study Specific Site Enrollment Enrollment Study Analysis Qualification Target Plan Enrollment Plan 46th Annual Meeting Washington, DC - 2010 6
  • 7. Recruitment and Enrollment Plan: Single Site Specific Study Enrollment Plan 46th Annual Meeting Washington, DC - 2010 7
  • 8. Recruitment and Enrollment: Site Specific Plan Definition • Template tailored to indication, study design • Includes recruitment resources / approach and targets for enrollment • Written hard-copy document • Site specific • „Agreement‟ signed by site staff 46th Annual Meeting Washington, DC - 2010 8
  • 9. Recruitment and Enrollment Plan: Site Specific Plan Content • Site‟s: – Enrollment target – Timeframe – Recruitment sources • E.g.: database, advertising, referrals, outreach – Subject identification activity to date – Barriers to recruitment and enrollment 46th Annual Meeting Washington, DC - 2010 9
  • 10. Recruitment and Enrollment Plan: Site Specific Plan Implementation Ongoing Communication Template Tailored to be Signed by developed Review site specific PI and SC by PM 46th Annual Meeting Washington, DC - 2010 10
  • 11. Recruitment and Enrollment Plan: Site Specific Plan Implementation • Sample template plan, tailored by Site Study enrollment expectations Site enrollment expectations 46th Annual Meeting Washington, DC - 2010 11
  • 12. Recruitment and Enrollment Plan: Site Specific Plan Implementation • Proactive identification of pitfalls • Signed by PI and Study Coordinator Identification and review of challenges to enrollment • Past study challenges Recruitment • Challenges unique to current protocol challenges • Creative approaches to proactively addressing Site signatures 46th Annual Meeting Washington, DC - 2010 12
  • 13. Maximize Meeting Enrollment Goals: Tracking Cumulative Enrollment Graph 450 Number of Patients Enrolled 400 350 300 250 200 150 100 50 0 Projected Enrollment per Plan Actual Patients Enrolled 46th Annual Meeting Washington, DC - 2010 13
  • 14. Maximize Meeting Enrollment Goals: Additional Tools • Study Coordinator teleconferences • Outreach – Advertising • Flyers/brochures in office – Local resources • Health Fairs • Community Groups – Hospital / health community newsletters – Clinical study postings on websites 46th Annual Meeting Washington, DC - 2010 14
  • 15. Maximize Meeting Enrollment Goals: Additional Tools • On-going communication – Regular site calls (e.g., weekly, bi-weekly) • Scripted and non-scripted dialogue – Site teleconferences – Enrollment metrics • Screened, enrolled completers – Projected – Actual – Total active / eligible sites 46th Annual Meeting Washington, DC - 2010 15
  • 16. Conclusions • Proactive approach – Thorough site feasibility and qualification • Enrollment plan – Introduction, development of study-specific template; implementation of individualized plans • On-going review of plan and tracking • Maximize knowledge and creativity • Contingency planning 46th Annual Meeting Washington, DC - 2010 16