Clinical Trial Recruitment in Aotearoa New Zealand - a qualitative study exploring barriers to recruitment and potential areas for improvement

This qualitative study investigates the recruitment barriers and potential areas for improvement in clinical trials, both in commercial and publicly funded settings in Aotearoa New Zealand. The study addresses the research question, ‘What are the barriers to recruitment into clinical trials and are there potential areas for improvement that could lead to increased recruitment?’.

The study utilised a qualitative descriptive methodology, with data collected through semi-structured interviews with thirteen experienced clinical research professionals from both the public and commercial clinical trial sectors. Initially, six interviewees were invited, and one declined. The five remaining clinical researchers referred an additional eight individuals, making a total of thirteen interviewees.

The findings revealed several recruitment challenges, including the lack of formal clinical research training in tertiary education or professional development. The interviewees agreed there is a need for diversified strategies, including digital marketing to engage new trial participants. Financial incentives for participants were highlighted as increasingly important, as clinical trials become more complex with longer durations. Additionally, low participation rates were identified, with interviewees suggesting that under 4% of the New Zealand population actively participate in clinical trials, with certain ethnicities’ rates even lower. All the interviewees acknowledged the necessity of Ethics Committees but their views on the speed of review and rigour varied. The usefulness of government tax rebates and incentives for clinical research was also deliberated.

This research highlights the importance of improving cooperation of both publicly and commercially focused researchers, to increase recruitment rates in New Zealand. The study identifies potential areas for improvement, which can inform the development of effective recruitment strategies, including the creation of a national register for clinical trials and the use of a central organisation like the New Zealand Association of Clinical Researchers (NZACRes) to promote synergy between public and private researchers. The study suggests incorporating government grants to cover salaries for independent auditors to ensure the quality of New Zealand's clinical trials remains world-class, and sponsorship for Māori and Pacifika students to engage with cultural health advocates to facilitate higher recruitment rates.