THE AUSTRALIAN TELETRIAL PROGRAM – AT LAST A SERIOUS AND UNIQUE PROGRAM INCREASING EQUITY IN RESEARCH IN AUSTRALIA
Dr Pascale Dettwiller1, Ms Jessica Southwood1, Professor Rachael Morton2, Professor Stephen McDonald3
1SA Health, Adelaide, Australia, 2University Of Sydney, NHMRC Clinical Trial Centre, Sydney, Australia, 3Centre Northern Adelaide Renal And Transplantation Service, Director Epicentre, Adelaide, Australia
Background: Regional patients are at increased risk of developing advanced diseases more rapidly than their urban colleagues. In regional South Australia (SA), most specialties, including nephrology, are delivered from FIFO metropolitan providers. Accessing care is challenging for regional patients with pre-existing high disease burden.
The Symptom monitoring WIth Feedback Trial (SWIFT) is an ANZDATA registry cluster (ACTRN12620001061921) randomised controlled trial (RCT) aiming to determine the clinical effectiveness and cost-effectiveness of symptom monitoring with feedback to clinicians and patients, compared with standard care in improving quality of life outcomes at 12 months for adults on haemodialysis.
Method: The methodology of converting a registry-based cluster RCT into a Teletrial is a radical approach that has been trialled in SA and a Melbourne-based oncology registry randomised clinical trial. The SA principal investigator’s team held preliminary consultations on the benefits for participants, for local dialysis centres, and ATP-SA support; the collaborative party ANZDATA and NHMRC Clinical Trials Centre at the University of Sydney, the SA Principal Investigator and ATP-SA developed the documentation to enable the original RCT to deliver a Teletrial RCT to all the dialysis regional centres. The Teletrial program provides financial and administrative support.
The process needed validation for transferability.
Results: To date, there are three main benefits for inclusion of regional participation:
- addressing inequity in RCT participation, ensuring diversity inclusion of historically vulnerable populations previously overlooked for RCT;
- local practitioners building professional development and capacity for regional trials research;
- finally, reliable data gives reliable outcomes.
Implications: The application to other trials will enable more regional participation, and increase the validity of collected data of relevance and transferability to other clinical settings.
Biography:
Dr Pascale Dettwiller is the clinical trial liaison officer for the Australian Teletrial Program in South Australia at the Department of Health and Wellbeing. She holds a Doctorate in Pharmacy and has been a successful recipient with her team of NRRC (2014) and MRFF (2017) for projects focusing on Indigenous Health. She holds an Adjunct Associate Professor position with the Rural Clinical School at the University of Adelaide and is a Rural Health Clinician at UNISA. She has relentlessly advocated for the regional population and their health burden. Working with the nephrology team to implement Teletrials in SA will make a difference for the regional and rural populations.