Recruitment for clinical trials is never simple, but when studies require participants to remain in a clinic or research facility for extended periods, the challenges multiply. Long in-house stays, common in early-phase pharmacology trials, demand more than a standard recruitment plan. They require a retention strategy that begins before the first participant arrives and continues throughout their stay.
Too often, CROs focus heavily on meeting enrollment targets without fully addressing what will keep those participants engaged, comfortable, and compliant over the course of days or even weeks inside a controlled environment. Overlooking this can lead to mid-stay dropouts, protocol deviations, and costly delays.
Long in-house stays place unique demands on participants. They may need to take extended time away from work, family, and daily routines. This level of disruption can create stress, especially if expectations are unclear or if participants feel unprepared for the length and nature of their commitment.
CROs that invest time during recruitment to walk potential participants through exactly what to expect, living arrangements, daily schedules, restrictions, and available amenities, are more likely to see stronger compliance once the study begins. Transparency builds trust, and trust sustains engagement.
When participants live onsite for an extended period, their physical comfort directly impacts compliance. Adequate sleeping arrangements, balanced meals, recreational spaces, and opportunities for limited social interaction can make a meaningful difference in their overall experience.
Small adjustments, like allowing access to reading materials, safe personal electronics, or supervised outdoor breaks, can help participants feel more at ease, reducing restlessness and frustration. The more positive the environment, the less likely participants are to withdraw prematurely.
Even during in-house stays, communication remains vital. Study staff should maintain regular, respectful interactions with participants, not just for procedural updates, but to check in on well-being. Participants who feel seen and valued are more likely to follow study requirements closely and less likely to disengage.
Technology can play a role here as well. Providing secure channels for participants to send non-urgent questions or updates to staff, or to communicate with family, can reduce feelings of isolation.
Long stays create a unique opportunity for close observation. Site staff should be trained to recognize early signs of participant disengagement, changes in mood, reluctance to participate in scheduled activities, or non-adherence to simple protocols, and address them immediately. Early intervention, whether through a conversation, a schedule adjustment, or an environmental improvement, can prevent small frustrations from escalating into withdrawal.
In 2025, with enrollment costs climbing and competition for qualified participants increasing, CROs cannot afford to treat long in-house retention as an afterthought. Every participant who leaves early can compromise data integrity and extend timelines, particularly in early-phase trials where sample sizes are small.
Recruiting for long stays needs to center around ensuring that beds are filled until the last scheduled data point is collected. By prioritizing comfort, communication, and transparency from the first recruitment conversation through the final discharge, CROs can reduce dropout rates, safeguard data quality, and deliver studies on time and on budget.
The organizations that anticipate the human side of extended stays will be the ones delivering reliable, high-quality outcomes in a highly competitive research landscape.
At AXIS, we focus on more than just meeting enrollment numbers. By creating an environment where subjects feel supported and valued, we not only maintain compliance but also protect data integrity, accelerate timelines, and deliver results our sponsors can trust.
