Impact & KPIs

Participant accessibility and representativeness

DCTs have significant potential to reduce logistical barriers and improve accessibility. This can enable the participation of traditionally underserved populations, ensuring that findings are applicable to more segments of the population. However, challenges persist in effectively reaching diverse populations due to varying levels of digital literacy, accessibility constraints, and operational complexities.

Recommendations

Deploy online recruitment strategies thoughtfully to increase trial visibility and outreach to diverse populations, particularly underserved groups. Tailor online outreach carefully to ensure balanced representation.

Engage local healthcare providers (e.g., specialised physician or nurse networks) and community health workers as active trial stakeholders, enabling access and fostering trust in remote or underserved areas.

Provide comprehensive digital literacy support and alternative participation methods to accommodate varying technological competencies and ensure equitable participation.

Systematically collect, monitor, and transparently report demographic data of trial participants to assess diversity outcomes, identify gaps, and inform improvements. In RADIAL, participants in the remote arm lived further away from the clinical trial arm compared to the participants in the site-based conventional and hybrid arm.

How Trials@Home reached these recommendations

While the study design for the RADIAL trial would have been suitable to empirically test how decentralisation of recruitment and trial activities affects the representativeness of the study population, the limited sample size did not allow for a reliable comparison. Thus, empirical research, case studies, semi-structured interviews, and ethics reviews informed these targeted recommendations.

Further reading

Publications

Learning from Remote Decentralised Clinical Trial (RDCT) experiences: a qualitative analysis of interviews with trial personnel, patient representatives and other stakeholders.

Coyle, et al
British Journal of Clinical Pharmacology
2021
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View poster version

The Impact of Operational Trial Approaches on Representativeness: Comparison of Decentralized Clinical Trial Participants, Conventional Trial Participants, and Patients in Daily Practice

de Jong, et al
Drug Discovery Today
2025
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Diversity in decentralized clinical trials: Prioritizing inclusion of underrepresented groups

van Rijssel, et al
BMC Medical Ethics
2025
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