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 enrolled participants who received chemotherapy locally and participants who did not. Participants who received chemotherapy locally lived substantially 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, P =. 004). This study highlights opportunities for alleviating financial and time burdens associated with clinical trial participation, promoting equity in clinical research. Trial Registration: ClinicalTrials. gov identifier: NCT04380337.