Older trial participants reject bad design, not technology
“Older patients don’t want digital.”
It’s one of the most persistent assumptions in clinical trial engagement – and one of the most misleading.
When participants struggle with a portal, miss an online task or ask for information to be repeated over the phone, age is often blamed. The logic seems straightforward: older adults are less comfortable with technology; therefore, digital engagement will always be a challenge.
But what if we’ve been diagnosing the wrong problem? Older adults aren’t rejecting technology. They’re rejecting experiences that are confusing, inaccessible and unsupported.
And frankly, so would the rest of us.
Older adults aren’t avoiding technology
Low digital confidence doesn't automatically mean low digital willingness. People in their sixties, seventies and beyond are managing finances online, booking travel, shopping and video calling family members as part of everyday life.
One patient with prostate cancer describes downloading every pathology report, surgical note and test result from his patient portal, before turning to ChatGPT to help him understand the information.
“I went to my patient portal, and got the results/readouts from every test I had. My surgical reports, postop recovery, pathology, every narrative and result I could get my hands on. A stack of PDFs. I went to ChatGPT.”
— 63-year-old prostate cancer patient.*
He isn’t an outlier. In our index of 35 patient-experience Reddit communities – covering oncology, cardiac disease, renal disease, neurology and post-surgical recovery – more than 1,800 people aged 60 and over are actively discussing diagnoses, treatment options and clinical trial opportunities. Combined with the finding that 86% of older adults are open to using digital health tools,1 the myth quickly begins to unravel.
Digital should enable participation
Older adults are already engaging with digital healthcare in ways that are often overlooked. They're accessing patient portals, researching treatment options and, increasingly, identifying clinical trial opportunities themselves.
This is especially true in oncology, where trial participation often sits alongside a new diagnosis, complex treatment decisions and periods of significant uncertainty.
“Just came from my 12-month follow-up with my oncology team at […]. I’m thrilled to share that I remain cancer-free after being treated through a clinical trial.”
— HPV+ squamous cell carcinoma patient, post-NIH trial, 12-month NED follow-up.*
This patient's journey challenges one of the industry's most persistent assumptions. Rather than waiting to be directed to a trial, they actively navigated the digital clinical trial ecosystem – finding a study online, enrolling, completing treatment and now celebrating being 12 months cancer free. Here, digital tools didn't replace clinical care; they helped a patient access it.
Stories like this challenge the assumption that older adults struggle to engage digitally. The opportunity for the industry is to ensure digital trial experiences are designed well enough to support the confidence and curiosity participants already bring.
The problem isn’t age. It’s design.
Joining a clinical trial is demanding enough without having to navigate multiple passwords, unclear navigation, tiny text, unfamiliar terminology and instructions that seem to assume you already know how everything works. At that point, the issue isn’t digital confidence – it’s usability.
Too often, digital trial experiences expect participants to adapt to the technology, rather than the technology adapting to them. That’s where age-inclusive design becomes so important.2 Not because older adults need special treatment, but because they highlight the weaknesses that poor design creates for everyone. Better engagement comes from better design – not from expecting participants to become more digitally confident.
Inclusive design is a health equity issue
When people are already willing to engage, poor design becomes more than an inconvenience – it becomes a barrier to participation. Some people may decide not to enrol, others may disengage part-way through a study, while some simply miss important information because it wasn't presented in a way that worked for them. That doesn't just affect participant experience – it can also lead to lower recruitment, poorer retention and gaps in the data collected throughout a study, ultimately affecting the quality and reliability of trial outcomes.
Those barriers don't affect older adults alone – they also impact people with lower health literacy, disabilities, caring responsibilities or limited digital confidence.3,4 More than 7 in 10 Medicare members report feeling a sense of confusion or uncertainty when navigating health information online,2 underlining how easily poor digital experiences can become barriers to participation.
The aim isn't to create separate pathways for older participants, but flexible pathways that allow more people to participate in the way that suits them best. That might mean offering telephone support alongside digital channels, involving caregivers where appropriate, making content available in multiple languages, providing practical training or making it easy for participants to move between digital and face-to-face support throughout their trial journey.
“Newbie caregiver here. My sweet, sweet mom (almost 68) was recently diagnosed. […] We had a telehealth consult with an […] specialist yesterday […] after initial testing with a local oncologist. She confirmed induction and we’ll reassess ASCT eligibility depending on how Mom responds. We also asked about clinical trials and were told about […] and […].”
— Daughter caregiver for 68-year-old newly diagnosed multiple myeloma patient.*
Ultimately, the question isn't whether older adults are willing to engage with digital clinical trials. Many already are. The challenge is ensuring digital experiences enable participation instead of creating barriers to it.
Let’s Talk
Creating more inclusive clinical trials starts with understanding the people they’re designed to serve. If you’re looking to improve participant engagement, accessibility and retention, let’s talk.
* We reviewed 1,876 recent Reddit posts and comments, as of 23 June 2026, including r/kneereplacement, r/cancer, r/cholesterol, r/prostatecancer, r/dementia, r/heartattack, r/lungcancer: 87, r/multiplemyeloma, r/pancreaticcancer and r/osteoporosis. As the data comes from self-selected, anonymous users, it is not statistically representative, but it offers a real-time view of patient experiences and concerns.
References
- CVS Health. Helping seniors navigate digital-first healthcare. Available here. (Accessed June 2026).
- HIT Consultant. Designing telehealth for every age: What providers need to know about serving older adults. Available here. (Accessed June 2026).
- Hatef E., et al. Development of an evidence- and consensus-based digital healthcare equity framework. JAMIA Open 2024;7:ooae136. Available here.
- NHS England. Inclusive digital healthcare: A framework for NHS action on digital inclusion. Available here. (Accessed June 2026).
