Background
A multifaceted approach is needed to overcome the geographic disparity in trials opportunity in non-metropolitan Australia. The Victorian TrialHub program aims to improve regional patient access to trials, partly through regional trials workforce development.
Methods
TrialHub is funded by the Australian Government Department of Health through the Community Health and Hospitals Program. Implementing a fellowship program has involved collaboration between central hub (Alfred Health (AH)) and regional sites.
At Bendigo Health (BH) where an established Cancer Trials program existed, the TrialHub program provided 0.5 EFT staffing for a dedicated doctor in clinical trials. Since January 2021 this fellow has worked on-site regionally, with virtual metropolitan mentorship provided.
At Latrobe Regional Hospital (LRH), AH haematology fellows rotating weekly to LRH commenced in May 2022. This has provided workforce for a dedicated haematology clinical trial clinic as well as establishing a research bone marrow pathology service.
Results
At BH the mentored trials fellow is an associate investigator on 13 open to recruitment studies, and principal investigator on a registry. Regular virtual attendance in metropolitan early-phase feasibility meetings is complementing local supervision and learning. The process of participant identification, consent, eligibility determination and review has been streamlined with dedicated trials staffing. Regular screening activities ensure reliable participant capture across multiple tumour streams.
At LRH over 3 months 18 patients across the breadth of haematologic malignancies were screened resulting in clinical trial enrolment at local and metropolitan sites. Travel remains a reason for individuals declining access to clinical trials in this early sample.
Conclusions
Establishment of a clinical trials fellowship program within the TrialHub program has enabled regional sites to develop clinical trials capabilities appropriate to respective stage of development, with infrastructure, support and mentorship provided by an established metropolitan unit.