Location plays role in access to diabetic eye disease trials
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FORT LAUDERDALE, Fla. — Patients who live in rural areas of the United States have to travel farther to participate in diabetic eye disease clinical trials, according to a study presented at the Retina World Congress.
Yoshihiro Yonekawa, MD, said that eye disease related to diabetes is a growing concern, but clinical trial sites are clustered in areas with higher populations.
“Diabetes is everywhere, but clinical trial sites are not,” he said. “Are there therefore geographic access disparities where some people have easier access to clinical trials while others don’t? Are our current samples that we have in clinical trial data representative of the general population that we treat as physicians?”
To determine geographic and socioeconomic predictors of access to clinical trials, Yonekawa and colleagues looked at the 73,00 census tracts in the contiguous United States and 621 clinical trial sites for diabetic retinopathy and diabetic macular edema for trials starting in 2017 or later. They mapped the center of each census tract to the clinical trial site and determined the total distance patients had to travel to participate in a clinical trial.
For patients in rural areas, 70.6% had to travel more than 90 minutes to reach a clinical trial site, while 68.4% of patients in urban areas had to travel less than 20 minutes. A rural location was associated with a driving distance of more than 60 miles (P < .001). In addition, patients in non-Northeast regions and those coming from areas with a higher percentage of the population below the 200% level of the federal poverty level had poorer access to clinical trials.
“There may be a lack of clinical trial sites in areas where there is the most diabetes in this country,” Yonekawa said. “This is something we can work on. It’s important for recruitment, retention, generalizability, and it’s just good for patient care, also.”
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Yonekawa Y. Geographic access disparities to clinical trials in diabetic eye disease in the United States. Presented at: Retina World Congress; May 12-15, 2022; Fort Lauderdale, Fla.
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