Mythbusters: Direct-to-Patient recruitment doesn't reach old(er) patients
Often when talking to clinical trial or program managers, I have encountered a common misconception:
"Digital patient recruitment campaigns don't reach my older patient populations!"
Let's look at the data to bust this widespread myth.
Most clinical trials are being conducted in oncology, CNS and autoimmune diseases. With some exceptions the burden of these diseases increases with age. Here is an example from a recently published global burden of disease study in CNS.
Unfortunately, I couldn't find conclusive information on the average age of clinical trial participants beyond anecdotal evidence. We can, however, estimate a sensible age range:
- Up to 35% of published trials exclude older people (above the age of 64) (Source: Shenoy and Harugeri, Perspectives in Clinical Research, 2015)
- As people age, they accumulate co-morbidities, which increases the chance of not meeting the eligibility criteria
- As people age, they get the diseases targeted by most clinical trials
Putting these things together, I would expect that most trial participants would be between 50 and 70 years old.
The target demographic is digital
Let's look at that data to bust the myth that the target demographic of clinical trials can't be easily reached by digital means and through direct-to-patient campaigns once and for all.
There is plenty of representative market research data that shows that patients' journeys are increasingly digital across the age spectrum. Older patients use digital tools (almost) just as much as younger ones.
When it comes to the DACH region, I would like to point the interested reader to the Pascoe Studie as well as the ePatient Survey. These representative market research studies show how patients use digital means across their patient journey from researching symptoms to connecting with healthcare professionals and managing their diseases.
Very recently, Syneos Health published a report exploring current ideas, expectations and concerns about AI from patients and caregivers. They have surveyed 1.000 patients in Europe and the US in atrial fibrillation, type 2 diabetes, breast cancer and Parkinson's disease.
While AI is not the topic of this post, their report contained a very relevant section on current technology and its adoption by patients.
The mean age of their respondents was 56. Their results show that older patients have adopted digital tools, just as the younger ones. Of those above the age of 65, 72% said that they own a laptop computer. This was just 3 percentage points less than those below 65.
Only in the category of wearable computing, namely smartphones, smartwatches and health wearables, such as Fitbit, was adoption significantly lower for people above 65.
The report also reconfirmed the finding from the Pascoe Studie that Google is effectively the gateway to health information.
People above 50 are also increasingly using Social Media.
In the US, 21% of Facebook users are above 55 years old (Statista). In the UK, it's 20% (The Guardian). Other countries, such as Germany are lagging behind. In Germany the share of users above 55 is only 11% (Statista). However, the share of these silver surfers is the fastest growing user segment on Facebook overall.
We at Viomedo serve patients across the age spectrum. Our online platform is used by people of every age. It actually is one of our main challenges to keep the product as easy to use for digital-natives and silver surfers equally.
Patients provide us data on their age in different places on Viomedo. Some input their age while registering with us, others, in order to use our matching system to find the right trial. In addition, we have data on the age of patients who have been enrolled into clinical studies through our platform.
Our internal data confirms both, the published usage information as well as the age range derived above. Let’s look into it.
Patients register with Viomedo in order to get notified about new trial opportunities. During the registration process they can, optionally, provide their age.
Unlike on Facebook, on Viomedo 50% of registered patients are above the age of 50.
37% of registered patients are between 50 and 70 years old.
As previously noted, the current target demographic of most clinical trials is rather narrow. As expected, we find that the majority (65%) of enrolled patients were between 50 and 70 years old.
In fact, in our sample, we don't see any patients above 80. That is despite the fact that these patients do use Viomedo.
At the same time, we don't see any patients below the legal age of 18. This shows that we haven't conducted any pediatric trials yet.