Clinical trials transform healthcare, but for many rural communities, access remains out of reach. While ongoing efforts aim to bridge these gaps, more work is needed to ensure equitable opportunities for every patient, regardless of location. Many rural communities face challenges such as geographic isolation, limited access, and lack of awareness, which continue to create barriers to clinical trial participation. These challenges contribute to the underrepresentation of rural patients in clinical trials, which means we may be missing valuable insights that could help us develop even more comprehensive and tailored treatment approaches. Bridging this gap goes beyond inclusion; it requires addressing historical inequities in clinical research to ensure that all patients, regardless of location, have an equal opportunity to benefit from medical advancements.
Clinical trials are essential for advancing medical knowledge and developing new treatments. They provide the evidence needed to determine the safety and effectiveness of interventions, ultimately leading to improved patient care. For example, the development of immunotherapies for various cancers has been a direct result of rigorous clinical trials, offering new hope to patients worldwide.
Despite their importance, access to clinical trials is not evenly distributed. A study by the National Library of Medicine found that approximately one in three clinical trial participants were rural residents, who often had to travel further to access these trial sites compared to their urban counterparts. This disparity is exacerbated for rural patients with complex conditions or deteriorated health who don’t have the strength to travel to urban trial sites.
Why Are Rural Patients and Communities Underrepresented in Clinical Trials?
One of the biggest reasons rural patients are underrepresented in clinical trials is geographic location and accessibility. With most trial sites located in urban centers, long travel distances become a significant challenge, especially for those already managing serious illnesses. On top of that, many rural patients and their healthcare providers are unaware of clinical trial opportunities due to limited outreach and awareness. Limited awareness of available clinical trials means many rural patients miss out on potential treatment opportunities. Even when trials are an option, economic challenges—such as the cost of travel, accommodation, and time off work; create additional barriers to participation. Healthcare access disparities also prevent timely diagnoses or referrals needed for trial participation.
Through our work recruiting patients for an advanced metastatic cancer trial, we have found that many participants are often unaware of key details about their condition, including whether they carry the specific biomarker required for eligibility and enrollment. This lack of awareness poses a significant challenge, as patients must return to their doctors for additional testing before they can proceed with enrollment. Given that this particular trial we’re supporting is for advanced metastatic cancer, time is of the essence, making delays in diagnosis and eligibility confirmation critical obstacles. Additionally, limited awareness extends beyond the medical condition itself—many patients are unaware of clinical trials as a treatment option, leading to hesitation and mistrust. For those facing a terminal diagnosis, the idea of an experimental treatment can feel overwhelming and daunting, further discouraging participation. At Leapcure, we recognize that bridging this trust gap is just as important as providing logistical support. By educating patients, advocacy groups, caregivers, and healthcare providers, we are working to ensure that rural patients not only have access to clinical trials but also the confidence to pursue them as viable treatment options. Additionally, our team of patient success interacts with patients daily, answering their questions and providing them with the emotional support needed to build trust, thereby helping them understand more about the clinical trial.
Why Rural Community Representation Matters
When rural patients are left out, the consequences are felt in clinical research. It’s important to include patients who have historically been marginalized and underrepresented in clinical trials to ensure equal access to opportunities for all. Additionally, it is scientifically important, as a lack of diverse patient participation can mean the data collected by trials may not fully capture the efficacy or safety of treatments across different populations. This impacts the medical advancements, and perpetuates historical health inequities and mistrust. Including rural patients improves research outcomes by ensuring treatments are tested across varied demographics which increases the reliability of the results.
However, another challenge we’ve seen working with rural patients is equitable access to care. So by dismantling the barriers preventing rural patients from participating in clinical trials, we can ensure they have the same opportunities for treatment as urban populations who are near sites. Lastly, when rural patients are included in clinical trials it addresses rural health disparities, strengthens healthcare systems, and contributes to a more equitable future for all communities, regardless of their location, economic status and access to specialized medical care.
Leapcure and Can Assist: Bridging the Gap for Rural Communities
While strides have been made, there is still much work to be done to address rural underrepresentation in clinical trials. Through our partnership with Can Assist, we’ve seen many challenges faced by rural patients firsthand, however, we’ve also seen the importance of bridging the gap through awareness, collaboration, accessibility and support of patients.
Can Assist is an organization committed to ensuring that all country cancer patients from NSW, have equitable access to the cancer care they need. Operating since 1955, Can Assist is comprised of 56 regional, rural and remote NSW branches. Their branches are 100% staffed by local community volunteers; 3000 + across the state who raise funds to deliver financial assistance to country cancer patients. They typically assist around 4,000 patients a year across thousands of requests; any age, any cancer. Assistance is bespoke and determined in direct communication with the patient. Leapcure has been working with Can Assist to support rural patients get access to clinical trials, while providing support with travel accommodation due to geographic location. Our partnership with organizations like Can Assist has been crucial in reaching rural communities, ensuring they aren’t left behind in clinical trials. By working together, we’ve been able to offer rural patients a chance at life-changing trials they otherwise might not have had access to.
Together with Can Assist, we’re ensuring equitable access to clinical trials and potentially life-changing care. To find out more, you can visit Can Assist to learn more about their vital work in NSW,and explore Leapcure’s empathetic approach to expanding clinical trial access . Finally, we understand every patient’s journey is unique – we invite you to share your healthcare story with us here to help shape the future of clinical research for rural communities.
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