Primary care researchers and rural health professionals are joining forces to provide cancer patients from rural Australia with more equitable access to clinical trials to improve their health outcomes.
While a considerable number of Australians live in rural areas, they are more likely to have poorer health outcomes and have less access to effective treatment than those living in cities. Innovative research into diagnostics and therapeutics is commonly conducted in hospitals inaccessible to rural patients, cutting them off from potential health benefits. PARTNER, a practice-based research network funded by the Medical Research Future Fund, is working to change that.
PARTNER is a national collaboration between rural general practice (GP) clinics and primary care researchers across Western Australia, South Australia, the Northern Territory, Tasmania, Victoria and Queensland. It will recruit 15 rural practices in each state to ultimately form an Australian rural clinical trials network. The network will use state-of-the-art software that helps to identify patients who might be eligible for hospital-based trials, and subsequently connect these patients via teletrials. In parallel, the network will build capacity in primary care to run practice-based clinical trials in rural areas. Connecting patients to both practice- and hospital-based trials will be equally important in boosting access to trials for rural patients.
PARTNER is supported by the Primary Care Collaborative Cancer Clinical Trials (PC4) group, one of 14 national collaborative cancer clinical trials funded by Cancer Australia which aims to increase research capacity and cancer clinical trials. PC4 focuses on developing trials relating to the role of primary care across the cancer continuum, including prevention, detection, survivorship and palliative care. Since 2009, PC4 has supported nearly 150 primary-care-based research studies recruiting more than 10,000 patients, with more than 2,000 patients living in rural areas.
PC4 maintains strong connections with both rural clinics and patients, and continues to engage rural communities across the country in the development of new trials. For instance, the Improving Rural Outcomes Trial recruited nearly 1,400 rural cancer patients in Western Australia to study the combined effects of community and GP level interventions to reduce time to cancer diagnosis. The development of PARTNER is being fast-tracked by PC4’s existing network of primary care professionals and researchers, as well as the concurrent launch of a new trial.
PARTNER in action: IC3 Trial
PC4 is using the PARTNER network to recruit patients for its new liver cancer screening trial called IC3, which is focused on improving the early detection of liver cirrhosis and liver cancer in primary care.
Hepatocellular carcinoma (HCC) is a low survival cancer with an increasing incidence rate in Australia, with cirrhosis being a principal risk factor. Patients with cirrhosis are recommended to undergo a surveillance strategy which leads to early diagnosis of HCC and improved survival. However, 60 per cent of patients diagnosed with HCC in Australia are not in a surveillance program due to under-recognition of cirrhosis.
The IC3 trial will begin recruiting shortly, aiming for 2,800 patients from 28 practices across the country. Over 900 of these participants will be recruited from rural Queensland, Victoria and Western Australia through the PARTNER network.
Like PARTNER, the IC3 trial is funded by the Medical Research Future Fund. It is becoming increasingly evident that working together with practice-based research networks such as PARTNER will help provide a platform for future clinical trials.