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IRT System For Clinical Trials

January 29, 2024

An IRT system is known by several names, including IVRS, IWRS, IXRS, and RTSM, but regardless of its name, the system provides a comprehensive set of capabilities for managing patient enrollment and drug supply operations throughout the clinical trial lifecycle.

Enrolling Patients, Randomization, and Blind Protection - as opposed to manual approaches, using the IRT to manage enrollment and/or randomization automates the process and eliminates human error. To preserve research blinding, the system enables for complicated protocol enrollment and randomization design and rigorously controls sensitive information such as treatment arm and drug treatment assignments. But that’s not all. Read on for all you need to know about the utility of an IRT system in modern clinical trials.

How are Patients Randomized using IRT?

The IRT/ interactive web response system will randomly allocate patients to treatment arms in a methodical manner. There are various commonly utilized approaches, including central, subject-stratified, and/or location-stratified randomization systems. The IRT will allocate the individual to the appropriate treatment arm during the randomization visit based on the programmed randomization process. In most cases, the IRT will also provide the individual with the medicine kit that corresponds to the randomized treatment arm.

IRT manages randomization in an automated and centralized manner. It can allow complicated classification and randomization designs that manual randomization cannot. Because randomization occurs without human interaction, it decreases human error. Furthermore, as with other parts of study management, the data is saved in the system for simple tracking. The automated randomization and medication assignment method avoids the need to maintain paper envelopes or cards at the location, where unblinded information might be compromised.

How Does IRT Help Protect the Study Blind?

The IRT/ interactive response system plays a crucial role in preventing unblinded trial data from being shared improperly. Maintaining the blind in blinded trials is critical to the trial's integrity since it prevents bias in how patients are treated. Without this safeguard, the study's findings may be thrown out. Overall, the IRT functions almost as a force field, shielding unblinded information, such as treatment arm and medicine kind, from individuals who should not have access to it.

Access to system functions is limited by user privileges, so only users who should have access to unblinded data in the IRT may view it. This information, like all of the activity captured by the IRT, may be transmitted to or integrated with another system. Controls are implemented to ensure that unblinded data is only transferred securely to the appropriate recipient.

What About Emergency Unblinding?

An interactive web response for system clinical trials is frequently equipped with emergency unblinding capabilities. This can be configured such that Principal Investigators can unblind patients at their locations in the event of an emergency. When the site has an emergency code breach, the system quickly alerts the research team. Often, the patient who was unblinded by the site is instantly removed from the research, prohibiting the IRT from assigning any additional drugs. The IRT can also provide patients access to the Medical Safety team, which can unblind any patient at any location without interfering with their continued participation in the trial.

What are the Benefits of Using IRT for Supply Management?

Individual kits in the depot and on-site are not labeled for specific patients. Instead, patients are given kits when they come for their appointments. As a result, shipments to locations only include enough product stock to fulfill patient demand for a set period of time and resupplies are triggered when stockpiles reach a predetermined level. Because goods are only assigned to patients when they come in for visits, this procedure increases medicine availability at the location while minimizing drug waste. Because the IRT knows what patients are at each location, their treatment arms, and the visit schedule, it can adjust the supply delivered to each site.

Controlling costs requires developing and maintaining an accurate prediction of product demand over the length of a clinical study. The IRT gives Supply Chain Managers real-time updates on patient registration and product inventories across the supply chain. This helps with budgeting, saves waste from hoarding goods, avoids stock-outs, and decreases the need for emergency steps to replace expired pharmaceuticals.

An IRT can also keep track of product expiry dates to ensure that the patient has enough time to take the medication before it expires. It can also notify study managers when expirations are approaching. Because of their limited shelf life, medications that must be actively controlled require this notice. Probably most importantly, an IRT provides supply managers with a comprehensive picture of available supplies at the main depot, subsidiary depot,, and site levels. As a result, they may change their inventory and distribution strategies to fit the current trial circumstances.

How Does IRT Provide Inventory Management?

The IRT/ interactive web response for clinical trials provides a number of capabilities to manage the supply chain in a trial, from the moment supplies are packaged and distributed at the depot to medicine assignment, drug returns, and destruction. When goods are physically packaged and made available in the system, transportation to another depot or location is initiated and tracked. When the Sponsor activates an IRT site, the system sends a request to the depot for an initial supply of medicine.

The depot fulfills the order and delivers it to the spot. When an order arrives at the site, personnel confirms receipt in the IRT and makes the medications accessible for patient assignment. Patients who visit the site are given a medicine kit from the center's inventory. An algorithm within the system is constantly checking the inventory at each station.

If the inventory falls below a certain threshold, the supply engine will submit a request to the depot to provide a replenishment. Shipments are made through this closed-loop procedure to accommodate newly enrolled patients, following visits, and any needed replacement stock.

Another key feature of the IRT that is sometimes neglected is the ease with which drug accountability, returns, and destruction may be accomplished. In many research, this procedure is still done manually, which is difficult and time-consuming. Sites can save time, enhance efficiency, and eliminate data input errors by switching the process electronically using the IRT.

What Role Does IRT Play in Patient Tracking and Reporting?

All patient and supply data contained in the IRT database is easily accessible via reports and data lookups. This gives the clinical and drug management teams real-time access to data, study parameters, and alarms.

This facilitates reviewing the research as it goes and making any required changes to things like enrollment or site inventory settings to match the exact condition of the trial at any given moment.

In Summation

Finally, an IRT enhances trial efficiency and the quality of accessible information over the course of a trial.

By incorporating an IRT earlier in the planning phase, solution providers are better positioned to assist complicated trial designs, avoiding typical errors and providing viable solutions and workarounds that have been utilized effectively in studies of a similar sort.

Since IRT systems link together clinical locations, study medicines, and patients, IRTs frequently add clarity and visibility to trial preparation. Including an IRT  earlier in the clinical trial planning phase may result in a better knowledge of supply chain demands, boosting the efficiency of inventory management, and hence cost savings over the duration of the study, benefiting sponsors and, eventually, the end patient. 

Want to know more about how Octalsoft can help you with a robust, hyperefficient IRT/IWRS?

Arun Janardhanan

Arun Janardhanan

This piece is co-authored by Nishan Raj, Senior Content Writer at Octalsoft.

Arun Janardhanan

This piece is co-authored by Nishan Raj, Senior Content Writer at Octalsoft.
Wherever there is the latest news, the newest culture shift, and the zaniest people, you are bound to find Mr. Arun Janardhanan, Senior Project Manager and Delivery Manager at Octalsoft. Arun discovered his love for technology early and quickly chose a career in IT. We at Octalsoft were lucky to scoop him up just in time before this jet setter zoomed off into the horizon. From ideating and innovating and on to managing executions of our products, critical to all strategic discussions, Arun is ever-present when it comes to developing new strategies, processes, structures, and organizational systems.

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