Literature DB >> 19362992

Access to medications and medical care after participation in HIV clinical trials: a systematic review of trial protocols and informed consent documents.

Andrea L Ciaranello1, Rochelle P Walensky, Paul E Sax, Yuchiao Chang, Kenneth A Freedberg, Joel S Weissman.   

Abstract

BACKGROUND: Expectations regarding receipt of medications and medical care after clinical trials conclude may inform decisions about trial participation. We describe the frequency with which these posttrial services are described in the protocols and informed consent forms (ICFs) of antiretroviral drug (ARV) trials.
METHOD: We systematically reviewed protocols and ICFs from Phase 3 and 4 antiretroviral trials in adults (> or = 12 years) from 1987 to 2006. Pharmaceutical industry-sponsored trials were selected from US Food and Drug Administration (FDA) documentation and Clinicaltrials.gov. Trials administered by the AIDS Clinical Trials Group (ACTG) were selected from the ACTG online registry. ACTG- and industry-provided protocols and ICFs were reviewed in full. The primary outcome was any mention of posttrial services, defined as any text regarding posttrial medications or medical care.
RESULTS: Complete trial documents were available for 31 (48%) of 65 trials meeting inclusion criteria. Documents from 14 trials (45%) mentioned any posttrial service: 12 (39%) mentioned medications, and 5 (16%) mentioned medical care. Payment for trial participation (74%) and for care for trial-related injury (94%) were mentioned more often than were posttrial services.
CONCLUSIONS: Posttrial medications or medical care was mentioned in the trial documents of <50% of reviewed antiretroviral trials. Improved efforts are needed to clearly describe posttrial services in clinical trial protocols and ICFs.

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Year:  2009        PMID: 19362992      PMCID: PMC2763544          DOI: 10.1310/hct1001-13

Source DB:  PubMed          Journal:  HIV Clin Trials        ISSN: 1528-4336


  16 in total

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2.  Freebies for subject 641: a discussion of the ethical prospect of providing drug trial subjects with post-trial access to the drug tested--a Canadian perspective.

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3.  Symposium: ethical considerations in HIV preventive vaccine research: examining the 18 UNAIDS guidance points. The 18 UNAIDS guidance points.

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5.  Creation of a drug fund for post-clinical trial access to antiretrovirals.

Authors:  Jintanat Ananworanich; Theshinee Cheunyam; Somsong Teeratakulpisarn; Mark A Boyd; Kiat Ruxrungtham; Joep Lange; David Cooper; Praphan Phanuphak
Journal:  Lancet       Date:  2004 Jul 3-9       Impact factor: 79.321

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7.  The challenge of assuring continued post-trial access to beneficial treatment.

Authors:  Christine Grady
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Authors:  Ezekiel J Emanuel
Journal:  Am J Bioeth       Date:  2005 Sep-Oct       Impact factor: 11.229

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10.  Inferior clinical outcome of the CD4+ cell count-guided antiretroviral treatment interruption strategy in the SMART study: role of CD4+ Cell counts and HIV RNA levels during follow-up.

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Journal:  J Infect Dis       Date:  2008-04-15       Impact factor: 5.226

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  5 in total

Review 1.  Human dignity as a basis for providing post-trial access to healthcare for research participants: a South African perspective.

Authors:  Pamela Andanda; Jane Wathuta
Journal:  Med Health Care Philos       Date:  2018-03

2.  An Ethical Imperative to Ensure Uninterrupted HIV Care Following Therapeutic Trials: One Experience in Peru.

Authors:  Katherine Garcia-Rosales; Karin Sosa Barbaran; Jessica Rios; Delia Pinto-Santini; Maria Del Rosario Leon; Jorge A Gallardo-Cartagena; John MacRae; Mey Leon; Javier Valencia-Huamaní; Esmelda Montalban; Pedro Gonzales; Ann Duerr; Javier R Lama; Rachel Bender Ignacio
Journal:  AIDS Patient Care STDS       Date:  2022-06       Impact factor: 5.944

3.  The patient's safety and access to experimental drugs after the termination of clinical trials: regulations and trends.

Authors:  Ricardo Eccard da Silva; Angélica Amorim Amato; Thiago do Rego Sousa; Marta Rodrigues de Carvalho; Maria Rita Carvalho Garbi Novaes
Journal:  Eur J Clin Pharmacol       Date:  2018-05-12       Impact factor: 2.953

4.  Reasons Why Post-Trial Access to Trial Drugs Should, or Need not be Ensured to Research Participants: A Systematic Review.

Authors:  Neema Sofaer; Daniel Strech
Journal:  Public Health Ethics       Date:  2011-07-11       Impact factor: 1.940

5.  Who should pay for the continuity of post-trial health care treatments?

Authors:  Roberto Iunes; Manuela Villar Uribe; Janet Bonilla Torres; Marina Morgado Garcia; Juliana Alvares-Teodoro; Francisco de Assis Acurcio; Augusto Afonso Guerra Junior
Journal:  Int J Equity Health       Date:  2019-06-03
  5 in total

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