Rural patients have been missing out on involvement in clinical trials, but the PARTNER network is set to address this glaring gap in rural health.
The nearly seven million people living in rural Australia have higher rates of hospitalisations, mortality, disease and injury, with poorer access to primary health services compared to their urban counterparts. And this is not just anecdotal.
Damning dataproduced by the Australian Institute of Health and Welfare (AIHW) indicates this disparity may be due to a range of factors, including:
Challenges in accessing healthcare or health professionals
Social determinants such as income, education and employment opportunities
Higher rates of risky behaviours such as tobacco smoking and alcohol use
Higher rates of occupational and physical risk
Successive governments have pledged and tried to address this rural health crisis, most notably by trying to encourage GPs to live and work in rural and remote areas. But another aspect of our health system might also help improve rural health outcomes. Access to rural clinical trials, which is where the ‘PARTNER Network’ comes in.
PARTNER Network and Rural Clinical Trials
Clinical trials are a critical part of our health system in the way they drive the development of new interventions, with studies showing that being involved in clinical trials may benefit a patient, pointing to data showing their health improves relatively to those not involved in trials.
However, due to the infrastructure and investment required to undertake clinical trials, they are generally located in urban and metropolitan areas, meaning rural clinical trials are a notional concept at best.
University of Melbourne’s Jon Emery, a professor of primary care cancer research and researcher Dr Kristi Milley, wrote about this ina recent article for the university, saying ‘We know that access to clinical trials can improve outcomes, quality of life and help patients be more engaged in their healthcare. However, clinical trials are often centred around hospital-based care and can prove challenging for people based in regional and rural areas to access due to time, cost and social disruption.’
This glaring absence of rural clinical trials has led to a team from the university bringing together prominent academic GPs from across the country to create the PARTNER Network.
What does this mean for rural clinical trials?
The formation of the PARTNER Network means that by 2025 there will be up to 90 regional GP practices partnering across the country in a joint initiative – led by Queensland Health – of six states and territories called the Australian Teletrial Program.
This sprang from a pilot run by Queensland Health and the Clinical Oncology Society of Australia between 2017 and 2020, during which, for example, an Airlie Beach resident was able to take part in a cancer drug trial run over 270kms away in Townsville.
The PARTNER Network will create opportunities for rural residents to be involved in rural clinical trials that they have up until now had difficulty accessing, with state-based coordinators helping connect research teams to individual rural practices wanting to participate in trials.
Cirrhosis and liver cancer to launch PARTNER rural clinical trials
Australia’s largest primary care cancer clinical trials group, Primary Care Collaborative Cancer Clinical Trials Group (PC4), will be the first step forward in the PARTNER network’s efforts.
The trial involves a new biomarker test to identify people who require screening for liver cancer and will recruit 2,800 patients at increased risk of cirrhosis using ‘TorchRecruit’, a platform created by the University of Melbourne that creates tailored algorithms to identify eligible patients to participate in the PC4 trials using electronic medical record data.
This will hopefully be just the first of many rural clinical trials, and as more general practices join the PARTNER network, there is the potential that it will become a major resource for helping rural patients gain equitable access to trials and better health outcomes.
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