{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:06:40Z","timestamp":1787875600227,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Clinical trials often face recruitment challenges. From the participant\u2019s perspective, barriers such as time commitment, travel to sites, and logistical burden, like arranging care duties or time off work, can deter enrolment. Decentralized clinical trials (DCTs) aim to address these by shifting activities closer to participants\u2019 homes and using online methods for recruitment and consent. This study explores recruitment strategies and remote eConsent implementation in a decentralized setting. The RADIAL trial, a three\u2010arm, open\u2010label, phase IV study in six European countries, enrolled participants with type 2 diabetes mellitus administering Insulin Glargine 300\u2009U\/ml. Recruitment strategies included online campaigns, search engine advertising, social media, and research database outreach. The remote consent process involved eConsent, telemedicine consultations, eIdentification, and eSignatures. Online recruitment campaigns generated a lot of impressions but led to very few pre\u2010screener completions or enrolments. In contrast, outreach through research databases proved more effective, accounting for 7 of the 8 enrolled participants in the decentralized arm. Major pre\u2010screening drop\u2010off occurred at the initial consent step, with 69% exiting before data collection. Eleven participants successfully completed eConsent; 4 others required remote paper\u2010based consent due to eIdentification issues. Implementing the multimedia\u2010enhanced eConsent system was resource\u2010intensive, complicated by country\u2010specific layouts and differing regulatory requirements. Tailored recruitment strategies and simplified remote consent processes are needed to enhance the accessibility and efficiency of DCTs. Further research should optimize targeting and keyword use in online recruitment.<\/jats:p>","DOI":"10.1002\/cpt.70042","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T13:44:32Z","timestamp":1756993472000},"page":"1067-1078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Recruiting and Consenting Decentralized Clinical Trial Participants\u2014Learnings from the Trials@Home\n                    <scp>RADIAL<\/scp>\n                    Proof\u2010of\u2010Concept Trial"],"prefix":"10.1002","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8558-2385","authenticated-orcid":false,"given":"Bart","family":"Lagerwaard","sequence":"first","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2037-2461","authenticated-orcid":false,"given":"Linda","family":"Rutgrink","sequence":"additional","affiliation":[{"name":"Sanofi  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"van Weelij","sequence":"additional","affiliation":[{"name":"Julius Clinical Research  Zeist The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Lipinska","sequence":"additional","affiliation":[{"name":"Julius Clinical Research  Zeist The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8245-137X","authenticated-orcid":false,"given":"Tina","family":"Bornemann","sequence":"additional","affiliation":[{"name":"UCB  Monheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Davey","sequence":"additional","affiliation":[{"name":"eClinicalHealth, a Cambridge Cognition Company  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8319-3658","authenticated-orcid":false,"given":"Jaime","family":"Fons\u2010Martinez","sequence":"additional","affiliation":[{"name":"Vaccines Research Area, Foundation for the Promotion of Health and Biomedical Research in the Valencia Region (FISABIO\u2010Public Health)  Valencia Spain"},{"name":"CIBER de Epidemiology y Salud P\u00fablica, Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Dupont","sequence":"additional","affiliation":[{"name":"International Diabetes Federation Europe  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4472-4468","authenticated-orcid":false,"given":"Diederick E.","family":"Grobbee","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1463-8243","authenticated-orcid":false,"given":"Mira G. 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