5 patient travel strategies to impact enrolment diversity in clinical research

According to the latest Center for Information and Study on Clinical Research Participation (CISCRP) report, “having to travel to the study clinic” is patients’ top-cited participation burden – and this is not a new phenomenon. Data from the last decade shows similar findings, such as this 2017 research showing “travel inconvenience” as the top reason for declining to participate in a trial.

The challenge persists, but, with a renewed focus from regulatory bodies and trial sponsors alike on improving enrolment diversity, the time is now to resolve the travel dilemma and provide greater access.

Broader enrolment issues also impact clinical trial diversity

Travel as the greatest hurdle to overall clinical trial participation naturally impacts any efforts to improve diversity in clinical research. If the majority of potential participants are impacted by travel-to-trial challenges, certainly socio-economic minority communities are as well. It stands to reason that solving travel issues more broadly will directly support diversity efforts.

As an exacerbating factor, recent research has revealed that clinical trial sites are often not located in communities with greater racial/ethnic minority groups. Lack of access to convenient and affordable transportation can also discourage people from these communities from participating in trials.

Minority communities are disproportionately impacted by certain diseases and conditions

In many cases, racial and ethnic minority groups are disproportionately impacted by certain diseases and conditions, as illustrated in this study about the need for diversity in liver cancer trials. While minority groups have been shown to be equally interested in clinical trial participation when compared with non-Hispanic whites, specific strategies to resolve participation barriers must be addressed - transportation foremost.

It is often difficult for minority groups to participate in clinical research due to lack of site access, ability to take time off work, or financial means to pay travel-related costs up front. Providing travel services removes these barriers, making research more accessible for all, while also making it easier for sponsors to meet the FDA’s latest diversity requirements.

5 travel strategies sponsors can employ today to improve trial diversity

1. Provide patient travel coordination: Customised per-patient travel support ensures you can reach patients wherever they are and provide them with streamlined access to your study. This can look like concierge-level support for flight, hotel, and ground transportation arrangements; booking assistance; all-hours patient call centre support; and special request assistance, such as for patients with mobility challenges.

Travel coordination also accounts for management of unforeseen travel delays and cancellations, extended hotel stays, and navigating co-occurring local events that may impact patients’ travel logistics. The goal is to eliminate most travel burdens from your trial participants’ and caregivers’ lives.

2. Offer timely reimbursements: Establish a system for timely, detailed review of patient expenses and provide patients and caregivers with a simple system for tracking those expenses and requesting reimbursement. Real-time review is ideal for fast approvals.

Related services can include collecting and reviewing out-of-pocket expense receipts, reimbursement distribution for approved expenses, management of any technical issues, and ongoing communication with patients and caregivers to answer any questions that arise.

3. Optimise clinical research stipend management: Expedite completed visit confirmation and extend timely payouts. Customising stipend solutions for individual sites can help to streamline processes and improve retention. Determine how your patients will receive their stipend - such as via debit card, check, or direct deposit – then distribute the funds and manage any issues or questions that come up for patients or caregivers throughout this process.

4. Coordinate global patient transport: Reach patients all over the world and fill international studies by providing door-to-door travel services and all related coordination. Go beyond covering costs and trying to reduce the number of site visits. Become the access point for the patients you wish to enrol and retain.

5. Cater to specific therapeutic areas and indications: Depending on your patients’ needs, you may wish to consider including travel services such as non-ambulatory support (e.g., wheelchair accessible vans), long-term housing, and on-site patient support personnel to meet, greet, and guide the patient at each stage of their journey. Patients with specific needs related to their diagnoses may also require shorter trips to accommodate their physical or mental conditions (e.g., fatigue is common in pulmonary and respiratory patients; patients with psychological conditions may benefit from additional anxiety management support or accommodations for support animals).

Resolving this long-standing barrier to entry won’t happen overnight, but plug-and-play solutions for sponsors are certainly available. When impacting diverse trial enrolment immediately is a priority, sponsors should have trial support vendor options that can ensure such improvements occur swiftly and smoothly.

Research access continues to evolve in the age of optimised clinical trials, so staying ahead of the curve is essential – and that starts with shoring up old roadblocks with fresh solutions. Many sponsors choose to outsource this effort, as navigating all the details individually requires extensive experience for maximum efficiency and optimal results. Reaching ideal patient groups for more inclusive research hinges on their ease of access, and that’s one barrier the industry can finally resolve for good with the right partners in play.