Could Decentralized Clinical Trials Make Clinical Research More Accessible?

Finding a clinical trial can often be just the first step for people interested in participating in medical research. Even when you meet the eligibility criteria for a study, participating may require back-and-forth trips to a research or academic center.

A recent study published in JAMA Network Open found favorable trends in participation among people who lived farther from research sites, as well as rural and underrepresented populations, after a decentralized clinical trial (DCT) program was implemented. 

Clinical trials are increasingly exploring ways to diversify participants by bringing the research directly to patients rather than requiring them to travel for care.

What Is a Decentralized Clinical Trial?

Traditional clinical trials typically require participants to visit a hospital, university, or research center to test the effectiveness of new medical approaches. In contrast, a decentralized clinical trial moves some — or all — trial activities closer to the participant — or even into the participant’s home. 

Depending on the study, this might include:

• Telehealth visits
• Remote consent
• At-home blood draws
• Remote monitoring
• Wearable devices
• Delivery of oral medications

But not every decentralized trial is completely remote. A clinical trial may still require participants to attend some in-person visits or procedures, but still offer more flexibility than traditional trials.

The Mayo Clinic program referenced in the study used remote consent, video telehealth visits, in-home phlebotomy, and device services across its sites. Some remote monitoring and medication-delivery capabilities were available on a more limited basis. 

RELATED: 5 Black Clinical Trials FAQs, Answered

Why Can Travel Be a Barrier to Clinical Trial Participation?

Traveling to a clinical trial site can be a huge barrier for some participants. 

The most common travel-related barriers include:

• Long distances to research centers
• Transportation challenges
• Time away from work
• Childcare or caregiving responsibilities
• Travel-related expenses
• Difficulty making frequent appointments

The study’s authors noted that time, travel, and financial commitments can make clinical trial participation difficult, particularly when trials are concentrated at academic medical centers. 

It’s important to understand that access to potentially life-saving medical research isn’t just about whether a trial exists — it’s also about whether a patient can realistically participate. 

What Did Researchers Find?

The study included 7,469 participants enrolled in 765 decentralized clinical trials between January 2024 and March 2025. 

Here were the key clinical findings:

• The percentage of participants living more than 120 miles from a Mayo Clinic site increased from 18.9 percent in early 2024 to 29.6 percent in early 2025. 
• Participation among people from rural areas increased from 16.6 to 24.9 percent over the study’s quarterly measurements.
• The proportion of participants from racial or ethnic groups classified by the researchers as underrepresented increased from 12.5 percent to 17.4 percent.
• More than 20 percent of participants were from rural areas, and 15.4 percent were from the study’s underrepresented racial/ethnic populations.

Keep in mind that this study was an observational quality-improvement analysis. The researchers said they could not conclude that the DCT program itself caused these increases. There could be other factors in play that caused greater participation in clinical trials.  

What Could This Mean for Black Patients?

Black patients have historically been underrepresented in many clinical trials. Research participation should reflect the populations who may ultimately use the treatments being studied. Bringing some trial activities directly into a patient’s home or community could potentially reduce logistical barriers. But technology and geographic access alone won’t solve every barrier to participation. Trust, awareness of available trials, and relationships with healthcare providers can all influence whether someone participates.

RELATED: Clinical Trials: What Black People Need to Know Before Participating

What Does a Decentralized Clinical Trial Look Like for a Patient?

Rather than driving several hours to a research or academic center for every study visit, a participant might complete some appointments by video, have certain laboratory work performed closer to home or in their home, and use a wearable device to send researchers health information remotely. However, experiences with decentralized clinical trials will depend on which trial you participate in. 

Some trials may require 50/50 in-person and at-home care, while others may be done entirely at home. Before you complete forms to participate in a clinical trial, ask the research team how much in-person attendance (if any) is required. 

Could a Decentralized Clinical Trial Be Right for You?

Decentralized clinical trials can provide a greater opportunity to patients who otherwise couldn’t access medical research without worrying about the logistical barriers to potentially life-saving treatment. However, it may not be suitable for everyone.

Here are some questions you can ask the research team to see if a decentralized clinical trial is right for you:

• Which visits must be in person?
• Can any visits happen by telehealth?
• Are transportation costs covered?
• Can lab work be done locally?
• Are devices or internet access provided?
• What happens if I have technical problems?
• How often will I need to travel to the research site?

Patients shouldn’t assume a clinical trial is out of reach simply because the research center is far away. Ask the study team what parts of participation can happen remotely or closer to home.

If you’re interested in participating in a clinical trial, visit BlackDoctor’s Clinical Trials Resource Center to find open trials for your health condition.