Remote technology and decentralized clinical trials could increase the likelihood of patient participation, according to a study published in JAMA Network Open. 

Researchers surveyed 1,183 cancer patients and survivors about their interest in clinical trials and their willingness to use remote interventions. Only 18% had participated in a cancer clinical trial. Meanwhile, 77%  reported they would join a trial if it were at least as easy to access as their regular care in terms of distance and frequency of visits, and 47% said they would participate even if it required extra travel time or visits. 

Patients older than 55 years old were significantly more likely to say they wouldn't join trials that required travel farther than their usual care site, while respondents in higher-income households were more likely to participate in research that required extra effort. 

More than 80% were willing to use the majority of remote interventions, like oral medications delivered and taken at home, providing informed consent electronically, and using apps or wearables. The study found the use of remote options was associated with an increased willingness to participate in clinical trials across all groups, especially among those who demonstrated the highest interest in trials, but also with respondents who initially said they didn't want to enroll in a trial under any circumstances.

However, 86% of respondents said it was important to have the option for in-person visits during fully remote clinical trials. 

"In this cross-sectional study of patients with and survivors of cancer, most respondents expressed a strong willingness to participate in cancer clinical trials. However, willingness to participate in trials requiring additional effort in terms of the frequency of visits and travel distance, compared with regular care, varied by income and age," researchers wrote.

"The use of remote technology and other decentralization tools that can decrease the need for travel to a trial site was associated with an increase in self-reported patient likelihood toward participation in cancer trials."

WHY IT MATTERS

The study's authors noted their survey focused on hypothetical clinical trials and didn't measure whether interest corresponds to actual trial participation. Meanwhile, cancer clinical trials can vary in the intensity of the intervention, which may affect patients' decisions to enroll. Respondents to a survey may also be more likely to demonstrate interest in a clinical trial than the general population. 

However, researchers said their survey demonstrates that patients accept decentralized trials, which could help lower-income and older patients become participants. 

"Our data show that patients with cancer and survivors of cancer are receptive to these technologies and tools, and use in the context of trials is associated with an increase in self-reported likelihood to consent if the technology or tool decreases the need to travel to a trial site. However, the degree to which respondents would be more likely to join a trial varied by approach, and the ability to have the option for in-person visits at a trial site when desired remained important," they wrote. 

THE LARGER TREND

Like other remote healthcare tools, decentralized clinical trials gained traction during the COVID-19 pandemic. Diversity among clinical trial participants is also an ongoing concern, which some experts argue could be improved by adding virtual or remote flexibilities. 

Meanwhile, there are a number of companies offering decentralized clinical trial technology, including Curebase, Reify Health, Medable and THREAD.