Retention Through Intention — Designing Truly Patient-Centric Trials In 2026

A strategically implemented solution combining decentralized clinical trial (DCT) elements — such as in-home trial visits, satellite (or “pop-up”) clinics, hybrid telehealth, and community-based and/or trial-naive sites — can enhance patient enrollment and retention significantly. This is often achieved through Site and Patient Support (S&PS) without changes to the protocol. Maximizing this strategy requires identifying potential drop-out risks during the protocol design phase, well before recruitment begins.

By identifying why patients may leave a study, sponsors can focus on targeted strategies to minimize the burdens placed on participants, their caregivers/families, and site personnel. These resources can also play a key role in facilitating enrollment and encouraging retention for patients joining mid-study, as well as supporting the home healthcare providers (HCPs) who enable hybrid protocols.

By collaborating with sponsors before a trial begins, a DCT solutions provider can identify potential attrition risks before the trial starts. Analyzing study design through the patient perspective, informed by resources like patient-reported outcomes (PROs) and focus groups, is invaluable for pinpointing trial participation pain points. It also provides insight into how DCT elements might impact the patient or site personnel.