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. 2021 Nov 12:24:100859.
doi: 10.1016/j.conctc.2021.100859. eCollection 2021 Dec.

Strategies implemented for accurate dispensing of an investigational new drug in a multi-site HIV prevention clinical trial

Affiliations

Strategies implemented for accurate dispensing of an investigational new drug in a multi-site HIV prevention clinical trial

Cindy Jacobson et al. Contemp Clin Trials Commun. .

Abstract

Safe practices for dispensing investigational product (IP) during clinical trials are not standardized and information in this regard is often limited. ASPIRE was a Phase 3 safety and effectiveness trial of a vaginal matrix ring containing 25 mg of dapivirine for the prevention of HIV-1 in women. The study enrolled 2629 women at 15 clinical research sites in Malawi, Uganda, South Africa and Zimbabwe who were randomized in a 1:1 ratio to receive either a vaginal ring containing 25 mg of dapivirine or a matching placebo vaginal ring. The vaginal rings and packaging were identical in appearance in order to maintain the study blind. A real-time, documented second check of the dispensing process was conducted by a second pharmacy staff. Frequent inventory counts and real time accountability audits were also useful for rapidly identifying a dispensing error. A total of 52,625 vaginal rings were dispensed with only three documented pharmacy dispensing errors. There were zero dispensing errors at 13 of the 15 sites with an overall rate of <1.0 per 10,000 rings dispensed. Our study findings support the implementation of a double check dispensing process and real time accountability audits as standard practice in clinical trials.

Keywords: Dispensing errors; GCP, Good Clinical Practice; ICH, International Council for Harmonisation; IP, Investigational Product; Investigational product; NCR, No-carbon required; PTID, Participant Identification; Pharmacy; Quality checks; SOPs, Standard Operating Procedures.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Example of partial prescription.
Fig. 2
Fig. 2
Example of a portion of a participant-specific dispensing record.
Fig. 3
Fig. 3
Sample vaginal ring label.
Fig. 4
Fig. 4
Example of an accountability record.
Fig. 5
Fig. 5
MTN-020 record of receipts of participant specific study product.

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