Ensuring Inclusivity in Decentralized Clinical Trials

Technology has made it possible for clinical trials to reach patients outside of traditional research settings. With wearable devices and digital platforms, decentralized clinical trials, also known as DCTs, reduce the need for frequent site visits, expand access, and make participation more convenient. 

While DCTs have opened the door for greater inclusivity, the complexity of digital tools can create new barriers. To reach more diverse patient populations, technology must be accessible, easy to use, and supported with thoughtful patient engagement strategies.

The Digital Divide Is Real 

DCTs aim to make research more accessible, but not every patient has the same starting point. Limited internet access, low digital literacy, and lack of reliable devices remain common barriers, especially in rural areas and among older adults. According to Pew Research Center, over 25% of adults over 65 don't use the internet. For these patients, unfamiliar platforms and complicated onboarding processes can discourage participation and lead to dropouts. 

Researchers should consider how remote monitoring tools affect participation when designing a trial. A recent study highlights how historically marginalized groups, including rural, older, and lower-income populations, are underrepresented in clinical trials, often due to a lack of trust and logistical barriers. Without intentional planning and outreach, DCTs risk reinforcing these same disparities seen in traditional trials. 

Why User-Friendly Design Matters

Even minor frustrations, such as too many login steps or unclear instructions, can become barriers to participation. Patients managing illness or caregiving responsibilities often don’t have the time or energy to troubleshoot confusing technology. For those with language barriers or impairments, accessibility features are critical for understanding instructions and using devices correctly.

Researchers should avoid platforms with complex or cluttered interfaces. Instead, they should prioritize clean layouts, large buttons, and easy-to-follow instructions. Built-in guidance, visual aids, and accessibility tools can also increase patient confidence and reduce the risk of dropout. 

Support and Training Build Confidence

Even with user-friendly tools, patients need support, especially those unfamiliar with wearables or digital platforms. Successful onboarding requires more than just handing over a device. It calls for clear tutorials, responsive help lines, and coordinated support from both study teams and vendors. Choosing partners that understand the importance of patient engagement and provide built-in support services helps improve adherence and reduce dropout risk.

Dedicated staff who check in regularly can ease anxiety and keep patients engaged throughout the study. When support is embedded in the process, patients are more likely to follow protocols and provide reliable data.

Inclusivity Leads to Better Trials

When technology is inclusive, more patients can participate and stay engaged in clinical trials. This results in a more diverse study population, stronger data, and more representative results. Inclusive trial design also improves recruitment, boosts retention, and reduces costly dropouts.

Digital health tools have the power to advance research, but only if every patient can comfortably use them. Confusing or complicated digital tools defeat the purpose of remote monitoring. When sponsors and researchers invest in accessibility and support, decentralized trials become what they’re meant to be: inclusive, efficient, and built around patient needs.

Learn how Vivalink provides ongoing support to strengthen patient adherence in DCTs.