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12 May 2022

Challenging barriers in the clinical trials landscape

  • VCCC Alliance

It is widely accepted that clinical trial medicine is good medicine, but with the ever-increasing scale and complexity of trials in Australia, how can we as a cancer workforce ensure as many patients as possible have access to participate?

May 20 is International Clinical Trials Day, and this year we're championing the emerging trial methodologies making a difference to regional, rural and culturally diverse populations: registry-based trials and teletrials.

To support the capacity building required in these emerging methodologies, the VCCC Alliance has adopted a coordinated approach that addresses the needs of consumers, clinicians and sites. Awareness of clinical trial types will be increased through dedicated inclusion into the Cancer Council Victoria’s new Clinical Trials brochure, while a new grassroots awareness campaign will specifically target knowledge gaps and directly address consumer concerns.

Additionally, educational resources – including Victoria-wide roadshows and online toolkits – will be freely available, while a full education and mentoring program will be developed to further raise the profile of registry and teletrials through advocacy.

With the ever-increasing scale and complexity of trials in Australia though, how can we as a cancer workforce ensure as many patients as possible have access to participate?

Clinical trials: a win-win for patients and the workforce

Clinical trials provide significant value to Australia’s healthcare system nationally, at an institutional level and at the level of private practice – and not only in a financial sense.

Greater participation in clinical trials can mitigate existing issues with equity of access and enable representative populations across rural, regional and culturally diverse communities. Trials provide patients with the opportunity to access new treatments, therapies and technologies, and crucially, trial participation can extend and improve a patient’s quality-of-life.

Clinical trials facilitate collaboration and partnerships, increasing institutional reputation, and contribute to an educated workforce, providing best quality patient care.

Complexity increasingly a key barrier

Although trial activity has increased, additional complexities in trials present a barrier to both participants and those conducting trials. The commitment to participate in trials can be burdensome, with multiple hospital visits – often at a distance from a participant’s home – a common reason not to participate.

Complex trials can also have narrow eligibility criteria, making it even harder for patients to take part. Furthermore, more complex trials are more difficult for emerging clinical trial units and early career researchers to undertake, leading to a disparity in representation and access, especially in rural and regional areas.

Emerging trial types breaking down barriers

The new trial methodologies of registry trials and teletrials challenge these barriers. Supporting simpler methodologies, these trials ask straightforward questions, allowing for wider selection criteria. These trial designs are also suited to providing 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 statewide.

Teletrials increase the opportunity for remote clinical trial access with the aim of increased participation and better cancer outcomes in regional and rural Victoria. 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 collaboration and innovation in Victorian Health Services.

Statewide collaboration set to bolster teletrials

Two statewide groups have been developed to support the teletrials initiatives in Victoria.

The Victorian Teletrials Taskforce brings together representatives from the Victorian Department of Jobs, Precincts and Regions, the Victorian Department of Health, the VCCC Alliance, Regional Trials Network and the Alfred Trials Hub. The taskforce provides a regular forum to share information and coordinate program design to encourage more clinical trials in Victorian Health Services using tele-medicine approaches across metropolitan and regional settings.

Alongside the Victorian Teletrials Taskforce, the Victorian Teletrials Collaborative is an operational group of organisational representatives from the VCCC Alliance, Regional Trials Network and Alfred Trials Hub. Its purpose is to utilise and share knowledge and expertise across Victoria to enhance collaboration and the sustainability of teletrials. Each organisation has identified opportunities to lead and support the state-wide teletrials effort to leverage opportunities and avoid duplication of effort. 

VCCC Alliance at the 2022 ARCS Annual Conference

Attendees at the upcoming 2022 ARCS Annual Conference in Sydney are encouraged to hear VCCC Alliance Head of Research Dr Mark Buzza present on the ‘Utilisation of novel trial methodologies to increase clinical trial participation’.

Dr Buzza will explore the VCCC Alliance’s successful implementation of five registry trials and the pilot teletrials project between 2017-20 as part of the clinical trials development program. The session will focus on the further uptake of these methodologies for clinicians, consumers, and sites, exploring the benefits and opportunities throughout Victoria, particularly for rural and regional areas.

REGISTER NOW: Monday Lunch Livestream | New trial Methodologies – Registry Trials and Teletrials

For more information on the VCCC Alliance Clinical Trial Innovations program, contact Duncan Colyeror to enquire about our work in Teletrials, contact Jessica Freeman.

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