Effective Recruitment Strategies for dTMS Trials in Older Adults with Depression

Research from McMaster University, in collaboration with other institutions, has explored the recruitment challenges inherent in clinical research, particularly in older adults with depression. The study aimed to investigate the cost-effectiveness of various recruitment strategies for deep transcranial magnetic stimulation (dTMS) trials among this population. The analysis examined recruitment data from a pilot study, assessing enrollment rates and conducting an enrollment-cost analysis. The results highlight healthcare provider outreach and Facebook advertising as effective recruitment methods, while also identifying potential facilitators and barriers to recruitment.

Key Takeaways:

• Recruitment challenges are inherent in clinical research, particularly in older adults with depression, due to medical comorbidities and infrequent help-seeking behavior.
• Neurostimulation techniques, such as dTMS, are often unfamiliar to patients within the healthcare system.
• Healthcare provider outreach to affiliated mental health clinics was the most effective recruitment method, with an enrollment-cost rate (ECR) of 0.00189 ($537.63 CAD/person enrolled).
• Facebook advertising was the second most effective recruitment method, producing an ECR of 0.00099 ($925.93 CAD/person enrolled).
• Social support from research personnel was a potential facilitator of recruitment, while time-intensiveness and accessibility challenges were noted as potential barriers.
• The study highlights the importance of investigating recruitment-related facilitators and barriers to dTMS interventions for older adults with depression.

Statistics:

• Over a 14-month period, the study received 185 referrals, yielding 22 enrollments.
• The enrollment-cost rate (ECR) for healthcare provider outreach was 0.00189 ($537.63 CAD/person enrolled).
• The ECR for Facebook advertising was 0.00099 ($925.93 CAD/person enrolled).

Sources:

• "Enrollment-Cost and Recruitment Effectiveness in a dTMS Clinical Trial for Older Adults with Depression: A Mixed-Methods Analysis of Recruitment Strategies, Facilitators, and Barriers." Brazilian Journal of Psychiatry, 2025.
• NewsRx. New Mental Health Diseases and Conditions Study Findings Have Been Reported from McMaster University (Enrollment-Cost and Recruitment Effectiveness in a dTMS Clinical Trial for Older Adults with Depression: A Mixed-Methods Analysis of ...). Mental Health Weekly Digest. October 13, 2025; p 592.