Tackling Waste in Clinical Research

Pre-Packaged Lab Kits Make Lives Easier, But at What Cost to Sites and the Environment?

Pre-Packaged Lab Kits Make Lives Easier, But at What Cost to Sites and the Environment?

I tried to tally them all, but there were just too many. I stopped counting at 153 pre-packaged laboratory kits that had expired before we ever had a reason to use them in the latest ongoing trial at our study site.

Receiving a shipment of such kits from a central lab is a routine occurrence for sites like ours that run research trials. Many are the study coordinators who have worked with the big-name labs—the ones whose kits come in bags or boxes, stuffed full of tubes, needles, vacutainer connections, and various bags and labels for packing and shipping.

Yes, they provide a convenient way to ensure proper blood collection at scheduled protocol visits. Yes, they make our lives easier as coordinators at busy sites…but at what cost to the sites and to the environment?

Recently, I spent two hours breaking down the pictured mountain of now-useless kits. Completing this task gave me time to think specifically about protocols and the practices surrounding such lab kits. I considered the complexity of the protocol our site had at hand, the contracted number of subjects we had agreed upon with the sponsor, and the amount of work it had taken to agree on a budget.

This is an early-phase trial with strict entry criteria, and the kits I broke down were for bloods to be drawn at specific time points. Our site has been open since last September, and we have only drawn screening samples on a participant’s first visit on two occasions. Even if we had enrolled more subjects earlier, a large majority of the kits shipped to us last year would have expired by now. Why such a large volume of kits for the initial shipment? How much money was wasted on the ones that expired?

Collectively, as an industry, we must address the issue of waste. Let’s consider study start-up; why not begin with a smaller number of start-up kits? Why not consider initial rate of enrollment and the length of time between visits?

In the past, I have asked a large central lab not to include 18 gage needles because we don’t use them; we draw bloods with a butterfly, which provides a more comfortable experience for the subject. The response I received was that the kits are pre-packaged and this was not going to change. Why could we not compromise or have site-specific kits based on need?

There must be companies who would love to take input on this challenge from all sides and synchronize this basic aspect of drug research and development between sites, sponsors, and central labs. Possibly the way to go is to use an online portal through which sites can resupply in smaller quantities, or an automatic resupply program to keep sites up to date for whatever time period is decided upon once a subject is enrolled. Whatever the means, let’s keep it simple and easy to navigate, with the shared goals of cutting down on expenses and being environmentally conscious.

I would be happy to work with a central laboratory or sponsor or vendor firm on such a project, and I am sure there are others in our industry who would lend their expertise.

As I mentioned, I stopped counting at 153 pre-packaged laboratory kits that had expired. Just look at that picture and try to tell me that this doesn’t represent a significant amount of waste when you consider that it happens at sites everywhere. Fiscal and environmental responsibility should be a shared responsibility between sponsors, central laboratories, and the sites.

Who wants to work on a project?

Author: Guest blogger Joy Jurnack, RN, CCRC, CIP, is with Northwell Health’s Division of Kidney Research at North Shore University Hospital, and is a member of the Academy Board of Trustees for ACRP.