Monitoring:
- Medical Monitoring (including 24/7 Medical Monitor coverage)
- To enhance regulatory compliance, our Medical Monitor is assigned to every project and is accessible 24 hours a day, every day to handle critical situations.
- Clarifying inclusion/exclusion criteria with the investigator.
- Providing consultation for potential safety issues or medical concerns regarding the clinical study.
Clinical Monitoring
- ClinQua CRAs perform comprehensive site management and monitoring activities to include the following types of monitoring visits:
- Pre study qualification visits
- Initiation visits
- Interim monitoring visits
- Close out visits
All activities are performed in accordance with ICH-GCP to ensure all investigational sites are compliant with all applicable regulations and protocol requirements.
The paramount responsibility of CLINQUA CRAs is to ensure patient rights, safety and data integrity. This is accomplished through ongoing review of the following:
- Informed consent process
- IRB/IEC approval
- Ensuring proper AE and SAE reporting and
- documented follow up
- Adherence to the protocol
- 100% source documentation verification
and data query clarification
- Investigational product administration
and accountability
- Protocol Compliance
- Site training and support
CLINQUA CRAs ensure ongoing site compliance via the continual ongoing review of the following:
- Site staff qualifications and experience
- Site staffing, facilities, storage and equipment
- Accessibility and eligibility of subjects
- Review and retrieval of regulatory documents
- Accurate and timely completion of all CRF and
- source data
In addition to on-site responsibilities each CRA
is responsible for site management documentation
and follow-up activities to ensure that site
staff remains motivated and focused.
These
activities include the following:
- Site Visit Report and follow-up letters
- Review of safety reports
- Providing site training and support through
communications
- Generation of status reports
- Maintenance of tracking tools/logs
- Facilitation of DCF resolution
CLINQUA CRAs complete comprehensive site visit
reports and follow-up letters which are provided
to the CLINQUA project management team within
10 working days of the visit; however, all
urgent issues are immediately reported to
project management. The visit reports provided
by the CRAs include detailed action plans for
all issues identified and all issues are tracked
through to resolution.
In summary the CLINQUA CRA plays a major role
in the successful conduct of a study. The
relationship developed between the CRA and the
site staff is such that there is a focus on open
effective communication with the CRA providing
training and support thus ensuring patient
safety, data quality and maximizing patient
enrolment.
Site Qualification (Pre-Study Visits)
CLINQUA's site management and monitoring
procedures will be performed in accordance with
ICH-GCP to ensure each investigative site%92s
compliance with regulations and protocol
requirements, and to enhance expeditious
enrollment of appropriate patients into the
clinical study. Regulatory documents will be
reviewed by the CRA on an ongoing basis during
the study conduct phase, including verification
of signed informed consent forms and
investigator IRB notifications.
The CLINQUA CRA will review the following
information at the pre-study site visit:
- Latest version of the Protocol for this
study
- Consent form process
- AE and SAE reporting procedures and
contact information
- Case report form completion and
maintenance
- Source documentation requirements
- Drug accountability requirements
In addition, to ascertain that an identified
investigational site is qualified to perform
this study to CLINQUA's expectations, the CRA
will review the following issues at the study
site and report this "study profile" in a site
visit report to CLINQUA and Sponsor:
- Principal investigator qualifications and
experience
- Site staffing, facilities, storage and equipment
- Adequacy of and accessibility to subject
population
- Access to source documentation
- IRB and ethics committee issues
- Laboratory and pharmacy certifications and
normal ranges (if applicable)
- Investigator agreement and indemnification
issues
- Recommendations for investigational site
approval or exclusion from the study
Sites that have recently had a pre-study site
visit performed by Sponsor or have worked with
CLINQUA in the preceding six months may be
exempt from a pre-study site visit. SPONSOR
will provide CLINQUA with a list of any exempt
investigators for this study.
Site Initiation
Once all regulatory documents and approvals are
received, a site initiation visit will be
scheduled for those investigators who are unable
to attend the investigators' meeting. During
this visit, the CRA will review the following
with the principal investigator and his/her
staff as appropriate:
- Study goals and obligations
- Investigator brochure
- Protocol procedures (with particular
attention to inclusion/exclusion criteria,
enrollment goals, adverse events, primary
efficacy variables and GCP compliance)
- Informed consent procedure
- Randomization procedure
- AE/SAE reporting
- CRF completion and error correction/need
for adequate source documentation
- Maintenance of the investigator binder
and site visit log
- Laboratory sample handling procedures
and results reporting procedures
- Clinical supply dispensation,
accountability and storage procedures
- Any other issue as deemed important to
the conduct of the study
Site Interims
The following issues are addressed at each
interim visit as appropriate:
- Informed consent
- Source document verification 100%
- CRF completion (may be done remotely)
- Expedient data retrieval and query
resolution
- Drug accountability
- Check and review of the regulatory
binder and its contents
- Clinical supply inventory
- SAE reporting
- Enrolment issues and targets
- Protocol amendments
- Significant protocol deviations
- Acceptability of facilities
- Personnel changes
- Updated regulatory documentation
- Laboratory sample handling
- Any other issue as deemed important to
the conduct of the study
Following each monitoring visit, CLINQUA will
complete follow-up letters and site visit
reports within 10 working days of the site
visit date These follow-up letters and
monitoring reports will be forwarded to Sponsor
on a monthly basis.
Preparation and submission of report on Serious Adverse Events
Reporting serious adverse effects to the sponsor and to the FDA, according to SOPs and FDA requirements
Preparation patient case narratives and SAE case narratives
Writing narrative descriptions of both significant and serious adverse effects for inclusion in the Final Study Reports
Protocol review/input
Conduct literature searches as required
Liaise with project managers, Study Physicians and Investigators to ensure best study design
Co-ordinate with data management to ensure compliance with internal systems
Ensure protocol undergoes internal review as per your company procedures
Informed Consent Form design
Assessing the completeness of Consent Form (review the Consent Checklist)
Assistance with the development of a project-specific consent form
Study Manual development
Study Manual Preparation procedures to enhance performance quality and consistency
Altering study methodology as required