4 Patient Engagement Mistakes That Sabotage Clinical Trial Recruitment

Strong Recruitment Starts with Strong Patient Relationships

Successful patient recruitment is one of the biggest challenges facing clinical trials today.

According to a recent study, 80% of trials fail to meet their initial recruitment target and timeline, delays which cost drug development companies upwards of $8 million per day in lost revenue. Another study found that 11% of clinical trial sites fail to enroll even one patient.

The impacts of clinical trial recruitment delays ripple throughout the healthcare ecosystem. Sponsors waste valuable resources developing therapies that never reach patients. The process wastes precious time for researchers, clinical trial sites, patients, and patient organizations. And, most importantly, life-changing therapies never get the chance to help those who need them most.

There are many reasons clinical trials ultimately fail to reach their recruitment targets, some of which happen during the enrollment phase itself. But too many trials fail long before enrollment begins because sponsors make avoidable mistakes in how they build relationships with patient communities.

Here are four of the most common mistakes:

1. Not Establishing Relationships with Patient Communities from the Beginning

Patients and families are not just customers – they are critical partners in the drug development process. When sponsors fail to engage with patients and patient organizations early in the pre-clinical phase, they miss the opportunity to establish collaborative relationships and build trust. If sponsors wait to make these connections until right when recruitment is about to start, outreach can be perceived as transactional and inauthentic.

The result? Patient communities will be less likely to champion the trial should recruitment challenges arise. And when patients have multiple trials to choose from, they may gravitate towards trials where sponsors engaged them early on, valued their input, and incorporated their feedback into protocol design.

2. Not Asking the Right Questions to Understand the Patient Experience

Early patient engagement, although important, is just the first step. Sponsors still need to ask the right questions and learn from lived experience.

When sponsors don’t take the time to interact with patients and families, understanding their journey from diagnosis through day-to-day disease management, they lose valuable context about what matters most in a trial.

These conversations – whether through surveys, focus groups, interviews, or other means – can reveal critical insights, such as patients’ risk tolerance, their preference for how often (and how) a therapy should be administered, and which efficacy endpoints are most important to them.

Glossing over these questions or making assumptions based on what another disease community values leads to protocol design decisions that discourage enrollment.

3. Not Understanding the Logistical Burdens of Trial Participation

A therapy might be safe and effective, but if trial participation is too burdensome, patients either won’t enroll, or they’ll drop out partway through.

Location is a major consideration. According to a 2020 study, patients listed travel (57%) as the second-most important factor when searching for or evaluating potential clinical trials. Yet sponsors often choose trial sites just in major cities, or they cluster locations in one region of the country. If a site is too far away, patients can’t participate, even if they would have been willing otherwise.

Distance isn’t the only travel barrier. For patients with certain diseases, flying can be prohibitive. Patients who use wheelchairs, are medically fragile, or require breathing support face transportation challenges that even the most well-intentioned sponsors may not have considered, especially if the trial involves repeated trips over several months.

But getting to the trial site is only part of the puzzle. Patients must also weigh the financial impact of participation. Taking time off work, driving long hours on the road, staying at hotels, eating at restaurants – these costs add up quickly. A 2025 survey by Mural Health found that patients routinely spend between $100-$1,000 per trial visit. 58% weren’t reimbursed for those expenses.

For families, the burden extends beyond finances. A child who participates in a clinical trial — or who travels with a participating family member — may face frequent school absences, which impacts learning and social development.

Sponsors who fail to engage the patient community ahead of time risk designing a trial that dooms the study before it begins.

4. Not Understanding How Patients and Families Learn About Clinical Trials

Sponsors who don’t understand how patients and families learn about clinical trials are operating blind. Without this insight, even well-designed trials remain invisible.
To effectively reach patients, sponsors must answer several key questions, including:

• Who are the trusted authorities in the disease space?
• Where/how do patients interact with one another?
• What do primary care doctors and specialists know about the disease and available trials?

This last question is especially important; a 2020 study found that 73.2% of survey respondents consider their healthcare providers the most trusted source of information about clinical trials. Understanding what providers know about these trials, and the details they share with patients, is crucial.

How PAS Helps Sponsors Avoid These Mistakes

Thankfully, these common engagement mistakes can be avoided.

Patient Advocacy Strategies (PAS) plays a crucial role in bridging the gap between life science companies and patient communities. By harmonizing engagement efforts and amplifying the patient voice, PAS helps create actionable insights that benefit both patients and biopharma companies.

PAS helps sponsors with:

• Community Engagement: PAS builds trusted, high-touch relationships with patient advocacy groups, individual patients and other stakeholders to ensure their perspectives are integrated into trial design and execution.
• Patient-Centric Trial Design: By focusing on patients’ needs and preferences, PAS helps design trials that are more appealing and accessible to potential participants.
• Health Literacy Materials: Customized clinical trial branding, study websites, educational materials, and other resources that mitigate barriers to enrollment, elevating trial awareness and proactively streamlining enrollment.

Are You Facing Patient Engagement Challenges?

Meaningful patient and advocacy partnerships start long before recruitment begins.

PAS helps sponsors build trust, gather insight, and engage communities with purpose.