Greater participation in clinical trials can mitigate existing issues with equity of access and enable representative populations across rural, regional and culturally diverse communities.
A key focus of our work is to reduce the barriers to clinical trial participation to ensure that the greatest number of patients can access trials across Victoria. By strengthening clinical trial workforce knowledge and capability, identifying and removing patient barriers to participation, and enhancing clinical trial units' capacity to deliver more clinical trials via novel trial methodologies, we’re boosting the number of Victorians accessing clinical trials.
Regional, rural and culturally diverse populations can experience poorer outcomes, with issues such as access, support and resources affecting a range of factors including quality of life and cancer survival rates. We’re focusing on the emerging trial methodologies making a difference to these groups: registry-based trials and teletrials.
These clinical trial methodologies allow for research and clinical trials to expand their reach and provide opportunities for new and underrepresented groups, including allied health and palliative care to participate in clinical research. Improving representation in these groups at more sites provides greater access to clinical trials state-wide.
Investigator-initiated trials (IITs) are established and managed by non-pharmaceutical researchers, such as clinicians and researchers working in a health institution. Launched in early 2020, the IIT toolkit provides these investigators with a one-stop-shop for setting up an IIT, offering clear guidance for the trial team on roles and responsibilities and providing resources to enable adherence to regulatory requirements and best practice.
The IIT toolkit continued to build momentum in FY 21/22, attracting over 15 per cent of monthly website visits year-round. Traffic to the IIT toolkit has grown in every key metric: we had 17,370 users (+28.7%) from 160 countries and total visits were up by over 26 per cent from the previous year.
Currently less than a third of patients recruited to a Victorian clinical trial live in a regional or rural area, and the teletrial model aims to overcome inequities through state-wide collaboration and innovation.
In 2018, supported by funding from the Victorian Government, we set out to enable broader access to cancer clinical trials across regional areas via teletrials. Four years on, the resulting Teletrials networked partnership strategy has proved a game-changer. The first Victorian clinical trial using the teletrials framework was TARGET-TP, a targeted intervention to mitigate the risk of cancer-associated thromboembolism. The trial was led by Peter Mac’s Associate Professor Kate Burbury, current chair of the VCCC Alliance Teletrials Project, and Dr Marliese Alexander, and has delivered practice-changing results.
