Extending the reach of clinical trials in regional, rural and remote Australia: lessons from the establishment of a statewide palliative care teletrial cluster.

Over a quarter of Australians reside in rural and remote areas, where access to clinical trials is limited. This disparity affects the generalisability of trial results and may contribute to poorer health outcomes for rural and remote patients. Teletrials - where regional, rural, or remote research sites are connected to primary research sites via telehealth - can overcome geographic barriers and improve access to clinical trials. In April 2024, Queensland launched a palliative care teletrial cluster recruiting to a clinical trial investigating medicinal cannabis for advanced cancer symptoms. This innovative model differs from other teletrial models in that it utilises existing health jurisdictions to create a statewide research cluster. This approach has the potential to expand clinical trial access throughout Australia. However, procedural delays in setting up satellite sites and high setup costs underscore the need to reform trial management processes and prompt discussion about optimal decentralised trial models to achieve universal access to clinical trials.