Wygenia Brisco, an assistant director at Abbott, was on the agenda at the Clinical Trials Congress, held earlier this winter in Las Vegas.

We’ve heard a few diplomatic and platitude-filled lectures on patient recruitment over the years. This is not Brisco’s style. At all. She’s more spirited, more inclined to plough through the obstacles in the field than discuss them obliquely. Her style is refreshing and engaging.

A trial was, like many in the industry, launched without a budget for recruitment. The goal was for one thousand patients with HIV. The study got behind, and funding was provided. “There was no budget for recruitment,” Brisco said bluntly. “We wanted to reduce our dropout rate. We wanted to energize the sites. We needed to do something. This trial is off. It’s delayed. We had a problem.”

Familiar Predicament

There were radio spots, posters for clinics, and other materials for the investigators. But the best solution, Brisco said, was a call center. “That trial finished on time,” said Brisco. “But we did have to put hundreds of thousands of dollars into that recruitment effort.”

In another study, set for a seven-year period, the goal was to sign up 10,000 patients in 18 countries at 300 different sites. Once again, at the beginning there was no budget for recruitment.

In that study, there was a typical curve ball: a change in inclusion criteria. That triggered a drop in patient enrollment from 250 patients per week to 70. “We were way off,” she said with grim satisfaction, in part because the story had another happy ending. It was a year late.

Dropping Sites

In that case, the media buys were not enough. “We implemented an aggressive site closure,” Brisco noted, in part because some site recruited no patients. They had been given a six week warning to get with the program. For whatever reason, some sites were not able to bring themselves up to speed. “So we shut them down,” she said.

Part of the strategy for sites that were retained, Brisco said, was to use tokens of appreciation that the sites would actually appreciate. This does not mean pens, pads and paper-clip holders, Brisco said. But certificates and note cards of a personal sort were appreciated.

Supporting The Troops

In other cases, the sites sought to enroll patients by sponsoring events with inspirational speakers, even a meal. This was judged a good investment. Said Brisco: “If they want to supply some sort of meal, we support that. If they want to bring in a speaker, we pay for that.”

It’s clear that Brisco is a resourceful and inventive strategist who has salvaged a few difficult situations that might have eluded managers with less experience. But even she sounds like she may be considering external consultants or suppliers outside the company to help with the next recruitment hurdle

“We have exhausted what my brain can think of in terms of ideas,” says Brisco. “We are considering external vendors now.”