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What Are Decentralized Clinical Trials?

What Are Decentralized Clinical Trials?

Traditionally, when patients want to participate in a clinical trial, they need to follow a conventional model that revolves around one central site. But with a decentralized clinical trial (DCT), patients have better and more convenient access, increasing participation and retention.

DCTs are studies executed through telemedicine and mobile/local healthcare providers. The processes and incorporation of modern technologies separate DCTs from the traditional clinical trial model.

Here is a full breakdown of decentralized clinical trials and how they benefit everyone involved.

How does a decentralized clinical trial work?

Similar to your traditional clinical trial, patients gain access to medicines and treatments that’ll be used for data collection. Where a decentralized clinical trial differs from a traditional model is where the treatment administration and collection occur. 

DCT services allow patients to stay in the comfort of their homes while participating. 

This allows sponsors and CROs to introduce convenient and efficient methods to participants while also collecting meaningful data.

5 Key Challenges Patients Face in Clinical Trials

The traditional model for patients can be burdensome, forcing some people who would otherwise benefit from participation from ever entering. Here are five challenges patients face.


In traditional trials, patients need to navigate back and forth to the clinical trial site for every visit. 

These trips add up over time and create a difficult decision for some patients. They’re left thinking, “Is my health worth the back and forth?” To highlight this point further, one study in the Oncologist journal showed the median one-way travel distance was over 25 miles.

The same study showed patients in lower income brackets traveled even further (58 miles).

Participation Costs

Patients with chronic disease and cancer may already struggle with the cost of care, but these can be exacerbated by traditional clinical trial participation. 

Between transportation, lodging, child care, and lost wages due to gaps in work—it’s not hard to imagine why some patients don’t sign up or stop showing up.


Time is more than money. Outside of missing work (and wages), patients lose out on personal time. They don’t get to spend as much time at home, at school, or at family engagements. When you factor in distance and travel methods, a patient could spend a full day attending a single trial visit that only requires an hour of actual on-site participation.

Work Time Lost

Clinical trial participation can take patients away from their work, which means lost wages. This puts a larger strain and burden on patients and is especially problematic for lower-income patients.

Home Obligations

Many patients are the heads of households or are the primary caregivers. It’s not always possible to find affordable child care. The choice may be between their health and taking care of their family.

The Patient Journey Within a DCT Model

Every patient journey starts with the consent and enrollment process, where patients can choose between traditional participation or a hybrid method. From there, patients who choose the latter option can set up a schedule that works for them (as long as protocols allow). There may even be chances for visits to take place at the participant’s workplace.

During the trial, patients will be assigned a nurse who will conduct several aspects of the study. This gives patients a trusted face to work with. It also allows for a greater deal of trust to be built between the patient and the nurse assisting them.

Once samples are ready for collection, patients have a choice of letting a courier collect them from their homes, or they can take them to a local lab. Finally, all data is documented, reviewed, and sent to the site according to protocol.

Patient Benefits in Decentralized Clinical Trials


DCTs bring the trial to the patient, reducing the travel burden for patients visiting trial sites.

Makes Participation Easier​​​

The choice of participating or not is made much easier since the trial can be brought to patients. By making participation easier, you’re also increasing the inclusivity and diversity of the patient population.

Build Trusting Relationships​

When it comes to medical conditions, it’s always easier to share information with someone you know or trust. Working one-on-one with a nurse they know, participating patients often feel more at ease speaking with a familiar face.

Increased Knowledge​

Having a nurse who knows the ins and outs of clinical trials and treatment administration often helps patients feel more informed. Their nurse can go over treatment details and any other pressing questions they may have.

Reduced Stress​

All of the above help lessen the burden and increase trust and knowledge. Every step contributes to the overall reduction of patient stress.

Post-COVID-19 Impact on Decentralized Clinical Trials

COVID-19 impacted the viability of clinical trials, suspending them due to the global pandemic. One group found that since the beginning of January 2020, about 1,000 organizations have reported a disruption. By May 2020, 1,162 trials were suspended.

Thanks to modern processes and technology, organizations can safely continue their trials with patients. Smart devices allow patients to record and send updates that make data collection easier for everyone. This data can also be collected at local healthcare facilities, ensuring patients don’t have to travel long distances each time.

Research Nursing for Decentralized Clinical Trials

Our ICH-GCP-certified nurses are prepared and trained to conduct several parts of the study. With extensive experience conducting studies and caring for diverse groups of patients, nurses become an extension of the clinical trial site itself. They also provide familiarity with their patients, increasing the level of trust between patients and care providers and the quality of data collection throughout the trial.

We are a global provider of home healthcare and remote nursing services for patients in clinical trials

Find Out More About Decentralized trials

To find out how we can support your clinical trial please fill out our form below. Alternatively, please email info@wrenhc.com