Advancing Clinical Trial Equity through Integration of Telehealth and Decentralized Treatment

Innovative strategies to increase clinical trial accessibility and equity are needed. We conducted a retrospective review of a phase II investigator-initiated trial to determine whether the modification of clinical trial design to decentralize study treatment can improve trial accessibility among underrepresented groups. Sociodemographic characteristics including area deprivation indices as well as study site travel distance, time, and costs were compared between those enrolled participants who received chemotherapy locally and those who did not. Participants who received chemotherapy locally lived significantly farther from the study site (median 95.90 vs 25.20 miles, p = .004), faced a greater time burden traveling to the study site (median 115.00 vs 34.00 minutes, p = .002), and had higher travel-related costs for a single trip to the study site (median 62.81 vs 16.51 dollars, p = .004). This study highlights opportunities for alleviating financial and time toxicities associated with clinical trial participation, promoting equity in clinical research.