Retention Isn’t a Site Problem Anymore
By Jeff Huntsman, Chief Commercial Officer
For years, retention has largely been treated as an operational challenge. How do we keep patients engaged? How do we reduce dropout? How do we recover when participation starts to decline?
At the recent SCRS Global Site Solutions Summit, I had the opportunity to ask sponsors, CROs, sites, and industry partners what they thought was really the problem. We chatted about everything from AI and site operations to investigator development and patient engagement, but one theme surfaced again and again:
The industry is starting to recognize that retention isn’t a site problem. It’s a study design decision.
What stood out to me at SCRS was a shift in mindset. Retention is no longer being viewed as something that happens after enrollment. Increasingly, it’s being recognized as something that must be built into a study from the very beginning.
Patients Don’t Drop Out Overnight
One of the most important discussions at SCRS centered on identifying early signals of dropout that often appear long before a patient leaves a study.
Patients rarely drop out because of a single event. More often, participation becomes increasingly difficult as competing responsibilities, logistical hurdles, and study demands begin to add up.
During a panel discussion with leaders from CISCRP, Takeda, Jumo Health, and Syneos Health, we explored what it takes to keep patients engaged throughout the study experience. A common theme was that successful retention starts with understanding the individual behind the protocol and recognizing barriers before they become reasons to leave a study.
What struck me is how much the conversation has evolved. Rather than focusing solely on why patients drop out, the industry is placing greater emphasis on understanding what patients need to stay engaged. Organizations that listen earlier, identify challenges sooner, and take action before those challenges become barriers will be better positioned to improve not only retention, but the overall patient experience as well.
Patient Support Can’t Be an Afterthought
Another recurring theme throughout the summit was the growing recognition that study participation creates a greater burden than we often acknowledge.
For patients, participating in research is rarely just about attending a visit. It’s balancing work schedules, family responsibilities, caregiving obligations, transportation, and countless other demands that compete for their time and attention.
Across multiple discussions, there was broad agreement that support services, like flexible scheduling options and home visits, are most effective when they’re treated as part of the study experience rather than a solution that’s offered only after challenges arise. Whether the need is logistical, educational, or personal, addressing barriers early can have a meaningful impact on both engagement and retention.
In many ways, this reflects a larger shift in thinking. The conversation is moving beyond asking patients to adapt to research and toward designing research that better supports patients.
Trust Begins Long Before Enrollment
Trust was another recurring topic, regardless of whether the conversation focused on patient engagement, diversity, obesity research, or future investigator development.
The message was remarkably consistent: trust cannot be built at the first visit.
Patients are more likely to consider research when it is introduced through trusted healthcare relationships and familiar care settings. That’s one reason community-based research models continue to gain momentum. Bringing research closer to where patients receive care creates familiarity, reduces barriers, and helps strengthen long-term engagement.
Expanding access remains critical, but access alone isn’t enough. Trust remains the foundation.
Innovation Must Solve Real Problems
Of course, AI was impossible to ignore at SCRS, but what I found most encouraging was that many conversations moved beyond the technology itself.
The most compelling examples weren’t innovation for innovation’s sake. They focused on solving specific operational challenges: reducing startup timelines, simplifying protocol review, improving patient identification, and helping site teams work more efficiently.
The common thread was practicality. Organizations aren’t looking for technology to replace people. They’re looking for tools that remove friction so teams can spend more time focused on patients and less time navigating process.
The lesson is simple: start with the problem, then find the right solution.
Where the Industry Goes Next
If there was one takeaway I left SCRS with, it’s that the industry is moving toward a more patient-centered definition of success.
For years, we’ve measured success through metrics like enrollment, retention, startup timelines, and study performance. Those metrics still matter, but many of the conversations at SCRS suggested they’re increasingly influenced by something deeper: the patient experience.
The organizations that will lead the next phase of clinical research aren’t simply asking how to enroll more patients or reduce dropout. They’re asking how to reduce barriers, strengthen trust, and create research experiences that fit more naturally into patients’ lives.
The future belongs to organizations that build studies around patients. If you’re ready to rethink what’s possible, you’ve found the right partner.