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Chennaq M, El Baraka S, Cherif Chefchaouni A, Benahmed H, Chaibi A, Belahcen MJ, Rahali Y. Manual versus automated chemotherapy preparation: A retrospective pharmaco-economic analysis. J Oncol Pharm Pract 2024:10781552241230889. [PMID: 38332625 DOI: 10.1177/10781552241230889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
INTRODUCTION The National Oncology Institute of Morocco's (NIO) shift to an automated cytotoxic drug preparation system (PHARMODUCT®) has prompted an evaluation of its economic and clinical impacts compared to traditional manual methods. METHODS A retrospective cost-benefit analysis over six months, extrapolated to annual projections, assessed initial investments, labour, equipment, drugs and consumables. Four commonly used chemotherapy drugs were analyzed, with a focus on the cost implications of drug waste in manual preparation versus the efficiency of vial-sharing in automated methods. RESULTS The automated system incurred a higher initial cost $2,934,098.74, but reduced annual drug consumption costs by 19.74% and drug-related expenses by $41,228.27. It also decreased personnel costs by $48,073.35. Despite the upfront investment, the system is projected to break even within two years, with no medication waste due to its vial-sharing capability. CONCLUSION The initial higher investment in pharmaceutical automation promises considerable long-term savings and efficiency gains. Despite the study's limited scope and duration, the findings endorse the adoption of automated systems in oncology pharmacy settings for sustainable financial management and improved clinical outcomes.
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Affiliation(s)
- Meryem Chennaq
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Ibn Sina University Hospital Center, Rabat, Morocco
| | - Soumaya El Baraka
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Ibn Sina University Hospital Center, Rabat, Morocco
| | - Ali Cherif Chefchaouni
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Ibn Sina University Hospital Center, Rabat, Morocco
| | - Houda Benahmed
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Aicha Chaibi
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- National Institute of Oncology, Ibn Sina University Hospital, Rabat, Morocco
| | | | - Younes Rahali
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
- Ibn Sina University Hospital Center, Rabat, Morocco
- Team of Formulation and Quality Control of Health Products, Faculty of Medicine and Pharmacy, Mohammed V University-Rabat, Rabat, Morocco
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Cerutti A, Ledoux T, Vantard N, Cerfon MA, Kimbidima R, Larbre V, Herledan C, Lattard C, Baudouin A, Caffin AG, Schwiertz V, Ranchon F, Rioufol C. Comparing different robots available in the European market for the preparation of injectable chemotherapy and recommendations to users. J Oncol Pharm Pract 2023; 29:1599-1612. [PMID: 36999226 DOI: 10.1177/10781552221143786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
INTRODUCTION Recent advances in technology have made it possible to develop robots for preparing injectable anticancer drugs. This study aims to compare characteristics between robots available in the European market in 2022 and to help future pharmacy users in their choices. METHODS Three sources of data were used: (1) a review of published articles in the MEDLINE database from November 2017 to end of June 2021 on chemotherapy-compounding robots used in hospital; (2) all manufacturers' documentation, and (3) demonstrations of robot operations in real hospital conditions and discussions with users and manufacturers. Robot characteristics included number of robots installed, general technical characteristics, type of injectable chemotherapy produced and compatible materials, productivity data, preparation control methods, residual manual tasks, chemical and microbiological risk management, cleaning method, software, and implementation time. RESULTS Seven robots commercialized were studied. Several technical characteristics have to be taken into account in selecting the robot whose match the specific needs of a particular hospital, and which often require rethinking the current production workflow as well as the organization of the pharmacy unit. In addition to increasing productivity, the robots improve the quality of production thanks to better traceability, reproducibility, and precision of sampling. They also improve user protection against chemical risk, musculoskeletal disorders, and needle wounds. Nevertheless, when robotization is being planned, there are still numerous residual manual tasks to keep in mind. CONCLUSION Robotization of the production of injectable anticancer drugs is booming within anticancer chemotherapy preparation pharmacy units. Feedback from this experience needs to be further shared with the pharmacy community regarding this significant investment.
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Affiliation(s)
- Ariane Cerutti
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Thomas Ledoux
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Nicolas Vantard
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Marie-Anne Cerfon
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Reine Kimbidima
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Virginie Larbre
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1- EA 3738, CICLY Centre pour l'Innovation en Cancérologie de Lyon, Lyon, Oullins cedex F-69921, France
| | - Chloe Herledan
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1- EA 3738, CICLY Centre pour l'Innovation en Cancérologie de Lyon, Lyon, Oullins cedex F-69921, France
| | - Claire Lattard
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Amandine Baudouin
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Anne Gaelle Caffin
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Vérane Schwiertz
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Florence Ranchon
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1- EA 3738, CICLY Centre pour l'Innovation en Cancérologie de Lyon, Lyon, Oullins cedex F-69921, France
| | - Catherine Rioufol
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1- EA 3738, CICLY Centre pour l'Innovation en Cancérologie de Lyon, Lyon, Oullins cedex F-69921, France
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Cherif Chefchaouni A, Boudina Y, Chennaq M, Belahcen MJ, Rahali Y. Contribution of an anticancer drug compounding robot in reducing the risks of manual preparation in a hospital pharmacy unit specialized in oncology. J Oncol Pharm Pract 2023; 29:1334-1342. [PMID: 35938183 DOI: 10.1177/10781552221118846] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In the last few years, pharmaceutical technology has evolved. In the field of oncology pharmacy, robots for the preparation of anti-cancer drugs have appeared to progressively replace manual preparation. The objective of this study is to evaluate the contribution of the robot in reducing the risk of manual preparation. METHODS The study was conducted at the pharmacy of the National Institute of Oncology in Rabat (May-August 2021). The method used to compare the two types of preparation is the method of analysis of failure modes, their effects and their criticality (FMECA). It will calculate the criticality index (CI = severity × frequency × detectability). The risks have been categorized into human, technical, and environmental risks. RESULTS The anticancer drugs reconstitution step was the most critical in manual preparation (CI = 126.7) and robotic preparation (CI = 40.7). The robot has made it possible to reduce several CIs of manual preparation including: musculoskeletal disorders of pharmacy operators -93 (89%), error in cancer drug and diluent selection -72 (60%), as well as lack of traceability -145 (97%). CONCLUSION The preparation robot has made it possible to reduce many of the risks of manual preparation, and constitutes an important advance in the field of oncology pharmacy.
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Affiliation(s)
- Ali Cherif Chefchaouni
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
- Ibn Sina University Hospital, Rabat, Morocco
| | - Yassine Boudina
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
- Ibn Sina University Hospital, Rabat, Morocco
| | - Meryem Chennaq
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
- Ibn Sina University Hospital, Rabat, Morocco
| | | | - Younes Rahali
- National Institute of Oncology, Ibn Sina University Hospital, Rabat, Morocco
- Team of Formulation and Quality Control of Health Products, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Yang C, Ni X, Zhang L, Peng L. Intravenous compounding robots in pharmacy intravenous admixture services: A systematic review. Medicine (Baltimore) 2023; 102:e33476. [PMID: 37171327 PMCID: PMC10174346 DOI: 10.1097/md.0000000000033476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND There is a lack of best evidence of intravenous compounding robots for hospital decision-makers. This study aimed to conduct a systematic review of intravenous compounding robots. METHODS A comprehensive search of relevant professional health technology assessment websites and electronic databases was conducted from inception to February 3, 2022. Current studies related to intravenous compounding robots were included in this systematic review. Two reviewers independently screened the literature, extracted data, and assessed quality. The results were reported by qualitative description because of heterogeneity in the characteristics of the data in the included studies. RESULTS Thirty-three studies were included. Effectiveness: The robots improved production efficiency compared with usual/manual preparation; however, the intravenous preparation process requires further optimization. Additionally, robots reduced the incidence of medicine residues, preparation errors, and preparation failures. The solution properties of intravenous admixture medicines were satisfactory, and the robots also contributed to error recognition. Safety: The robots reduced product pollution and environmental pollution, but vigilance is still required to ensure that pollution stays low. The robots also reduced the incidence of health damage to technicians. Economy: The robots reduced material costs in these studies; however, whether they can reduce labor costs remains unclear. Social suitability: Technicians had a high degree of satisfaction with the robots, but few relevant studies focused on this aspect. CONCLUSIONS Intravenous compounding robots have certain advantages in terms of effectiveness, safety, economy, and social adaptability.
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Affiliation(s)
- Chunsong Yang
- Department of Pharmacy, West China Second Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xiaofeng Ni
- Department of Pharmacy, West China Second Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Lingli Zhang
- Department of Pharmacy, West China Second Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Lijuan Peng
- Department of Purchasing, West China Second Hospital, Sichuan University, Chengdu, China
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5
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Vo N, Desmaris R, Brandely-Piat ML, Vasseur M, Rieutord A, Aboudagga H. [Robotic production of injectable anticancer drugs in hospital pharmacies]. Bull Cancer 2023:S0007-4551(23)00152-2. [PMID: 37105854 DOI: 10.1016/j.bulcan.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 04/29/2023]
Abstract
INTRODUCTION Following the 2005 decree on securing the medicine supply chain, the production of "chemotherapies", anticancer drugs (cytotoxic, cytostatic, immunotherapy), was centralised within hospital pharmacies. To cope with increasingly growing activities, pharmacies are moving towards robotisation. This work offers feedback from four French sites pioneers in robotic production. MATERIAL AND METHOD A review of the literature was carried out on the PubMed and Google Scholar scientific databases and GERPAC publications relating to the robotic production of chemotherapy preparations. This review allowed to select 25 articles. RESULTS The robotisation of the production of "chemotherapies" requires infrastructural prerequisites, a reengineering of the manufacturing process and the patient journey. This impacts all the parties involved in this complex process. The "cobotisation" concept or collaborative robotics must be anticipated by the teams. Robotisation is an institutional decision, which must be owned by the pharmaceutical team and endorsed by the medical team and management. DISCUSSION/CONCLUSION For reasons of optimisation, safeguarding and management of human resources, a large number of centres get equipped with robotic systems. Robotic preparation should extend to other non-hazardous preparation, as it is already the case in other countries. This strategic view should be carried out today to anticipate problems, ensure safety and improve the healthcare quality.
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Affiliation(s)
- Ngoc Vo
- Gustave-Roussy, Département de pharmacie clinique, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Romain Desmaris
- Institut Curie, département de pharmacie clinique, 8, rue Thuillier, 75005 Paris, France
| | - Marie-Laure Brandely-Piat
- Service pharmacie, groupe hospitalier Paris centre, Site Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Michèle Vasseur
- Pharmacie centrale, centre hospitalier universitaire de Lille, rue Philippe-Marache, 59037 Lille cedex, France
| | - André Rieutord
- Gustave-Roussy, Département de pharmacie clinique, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Hail Aboudagga
- Gustave-Roussy, Département de pharmacie clinique, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
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Kennedy K, Vu K, Coakley N, Daley-Morris J, Forbes L, Hartzell R, Lessels D. Safe handling of hazardous drugs. J Oncol Pharm Pract 2023; 29:401-412. [PMID: 36373754 PMCID: PMC9900183 DOI: 10.1177/10781552221135121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: This evidence-based practice guideline was developed to update and address new issues in the handling of hazardous drugs including being compliant with NAPRA (National Association of Pharmacy Regulatory Authorities) and USP 800 (United States Pharmacopeia) standards, the use of personal protective equipment and treatment in diverse settings including in the home setting. Methods: This guideline was developed from an adaptation and endorsement of existing guidelines and from three systematic reviews. Prior to publication, this guideline underwent a series of peer, patient, methodological and external reviews to gather feedback. All comments were addressed and the guideline was amended when required. This guideline applies to and is intended for all health care workers who may come into contact with hazardous drugs at any point in the medication circuit. Results: The recommendations represent a reasonable and practical set of procedures that the intended users of this guideline should implement to minimize the opportunity for accidental exposure. These recommendations are not limited to just the point of care, but cover the entire chain of handling of cytotoxics from the time they enter the institution until they leave in the patient or as waste. Conclusions: Decreasing the likelihood of accidental exposure to cytotoxic agents within the medication circuit is the main objective of this evidenced-based guideline. The recommendations differ slightly from previous guidelines due to new evidence.
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Affiliation(s)
- Kardi Kennedy
- Cancer Services, Kingston Health Sciences
Centre, Kingston, Ontario, Canada
| | - Kathy Vu
- Safety Initiatives Systemic Treatment Program, Ontario Health,
Cancer Care Ontario, Toronto, Ontario, Canada,Teaching Stream, Leslie Dan Faculty of Pharmacy, University of
Toronto, Toronto, Ontario, Canada,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto,
Ontario, Canada
| | - Nadia Coakley
- Department of Oncology, McMaster University, Hamilton, Ontario,
Canada,Ontario Health's Cancer Care Ontario's Program in Evidence-Based
Care, McMaster University, Hamilton, Ontario, Canada,Nadia Coakley, Department of Oncology,
McMaster University, Hamilton, ON, Canada; Ontario Health's Cancer Care
Ontario's Program in Evidence-based care, McMaster University, Juravinski Site
G-227, 1280 Main St W, Hamilton, Ontario, Canada L8N 3Z5.
| | - Jennifer Daley-Morris
- Oncology Pharmacy & Systemic Therapy Suite, Southlake Regional Health
Centre, Newmarket, Ontario Canada
| | - Leta Forbes
- Systemic Treatment Program Ontario Health, Cancer Care Ontario,
Durham Regional Cancer Center, Oshawa, Ontario, Canada
| | - Renee Hartzell
- Kingston Health Sciences
Centre, Kingston, Ontario, Canada
| | - Darrilyn Lessels
- Lakeridge Health, Durham Regional Cancer Center, Oshawa, Ontario,
Canada
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Shin S, Koo J, Kim SW, Kim S, Hong SY, Lee E. Evaluation of Robotic Systems on Cytotoxic Drug Preparation: A Systematic Review and Meta-Analysis. Medicina (B Aires) 2023; 59:medicina59030431. [PMID: 36984432 PMCID: PMC10056266 DOI: 10.3390/medicina59030431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/15/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023] Open
Abstract
Background and Objectives: With the increased prevalence of patients with cancer, the demand for preparing cytotoxic drugs was increased by health-system pharmacists. To reduce the workload and contamination of work areas in pharmacies, compounding robots preparing cytotoxic drugs have been introduced, and the use of the robots has been expanded in recent years. As reports on the comprehensive and quantitative evaluation of compounding robots remain lacking, a systematic review and meta-analysis were conducted to provide descriptive and quantitative evaluations of the accuracy of preparing injectable cytotoxic drugs. Materials and Methods: A systematic review and meta-analysis were conducted using published studies up to 2020. To identify eligible studies, PubMed, EMBASE, and Cochrane Library were used. All studies reporting the outcomes relevant to drug-compounding robots such as accuracy, safety, and drug contamination were included. Outcomes from included studies were descriptively summarized. Drug contamination by the robot was quantitatively analyzed using the odds ratio (OR) with a 95% confidence interval (CI). The risk of bias was assessed using the Risk of Bias Assessment tool for Non-randomized Studies (RoBANS). Results: A total of 14 compounding robot studies were eligible for review and 4 studies were included in the meta-analysis. Robotic compounding showed failure rates of 0.9–16.75%, while the accuracy range was set at 5%. Two studies reported that robotic compounding needed more time than manual compounding, two reported that robotic compounding needed less time, and one just reported preparation time without a control group. In a meta-analysis regarding the contamination of the compounding area, manual compounding was associated with lower contamination, although the result was not statistically significant (OR 4.251, 95% CI 0.439–51.772). For the contamination of infusion bags, the robot was associated with lower contamination (OR 0.176, 95% CI 0.084–0.365). Conclusions: Robotic compounding showed better accuracy than manual compounding and, without control groups, showed a high accuracy rate and also reduced the risk of drug contamination and compounding workload. The preparation time of the robot was not consistent because the type of robot and introduced system were different. In conclusion, robotic compounding showed mixed results compared to the manual compounding of drugs, so the system should be introduced considering the risks and benefits of robots.
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Affiliation(s)
- Sangyoon Shin
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Jamin Koo
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Suk Won Kim
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Seungyeon Kim
- College of Pharmacy, Dankook University, Cheonan 31116, Republic of Korea
| | - So Yeon Hong
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
- Department of Pharmacy, Seoul National University Bundang Hospital 82, Gumi-ro 173, Bundang-gu, Seongnam-si 13620, Gyeonggi-do, Republic of Korea
| | - Euni Lee
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea
- Correspondence: ; Tel.: +82-2-740-8588
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Ml H, T W, Jq Z, Yj S, Tj G, Lk Z, J L, Jf Y. Evaluation of external contamination on the vial surfaces of some hazardous drugs that commonly used in Chinese hospitals and comparison between environmental contamination generated during robotic compounding by IV: Dispensing robot vs. manual compounding in biological safety cabinet. J Oncol Pharm Pract 2021; 28:1487-1498. [PMID: 34162245 PMCID: PMC9465550 DOI: 10.1177/10781552211023571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives The aims of the study were to evaluate the external contamination of
hazardous drug vials used in Chinese hospitals and to compare environmental
contamination generated by a robotic intelligent dispensing system (WEINAS)
and a manual compounding procedure using a biological safety cabinet
(BSC). Methods Cyclophosphamide, fluorouracil, and gemcitabine were selected as the
representative hazardous drugs to monitor surface contamination of vials. In
the comparative analysis of environmental contamination from manual and
robotic compounding, wipe samples were taken from infusion bags, gloves, and
the different locations of the BSC and the WEINAS robotic system. In this
study, high-performance liquid chromatography coupled with double mass
spectrometer (HPLC-MS/MS) was employed for sample analysis. Results (1) External contamination was measured on vials of all three hazardous
drugs. The contamination detected on fluorouracil vials was the highest with
an average amount up to 904.33 ng/vial, followed by cyclophosphamide
(43.51 ng/vial), and gemcitabine (unprotected vials of 5.92 ng/vial,
protected vials of 0.66 ng/vial); (2) overall, the environmental
contamination induced by WEINAS robotic compounding was significantly
reduced compared to that by manual compounding inside the BSC. Particularly,
compared with manual compounding, the surface contamination on the infusion
bags during robotic compounding was nearly nine times lower for
cyclophosphamide (10.62 ng/cm2 vs 90.43 ng/cm2), two
times lower for fluorouracil (3.47 vs 7.52 ng/cm2), and more than
23 times lower for gemcitabine (2.61 ng/cm2 vs
62.28 ng/cm2). Conclusions The external contamination occurred extensively on some hazardous drug vials
that commonly used in Chinese hospitals. Comparison analysis for both
compounding procedures revealed that robotic compounding can remarkably
reduce environmental contamination.
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Affiliation(s)
- Hao Ml
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wang T
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Personalized Drug Therapy Key Laboratory of Sichuan Province, Chengdu, China
| | - Zhu Jq
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Personalized Drug Therapy Key Laboratory of Sichuan Province, Chengdu, China
| | - Song Yj
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Personalized Drug Therapy Key Laboratory of Sichuan Province, Chengdu, China
| | - Gong Tj
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Personalized Drug Therapy Key Laboratory of Sichuan Province, Chengdu, China
| | - Zou Lk
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Liu J
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Jf
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Personalized Drug Therapy Key Laboratory of Sichuan Province, Chengdu, China
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9
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Riestra AC, López-Cabezas C, Jobard M, Campo M, Tamés MJ, Marín AM, Brandely-Piat ML, Carcelero-San Martín E, Batista R, Cajaraville G. Robotic chemotherapy compounding: A multicenter productivity approach. J Oncol Pharm Pract 2021; 28:362-372. [PMID: 33573462 DOI: 10.1177/1078155221992841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this study is to compare productivity of the KIRO Oncology compounding robot in three hospital pharmacy departments and identify the key factors to predict and optimize automatic compounding time. METHODS The study was conducted in three hospitals. Each hospital compounding workload and workflow were analyzed. Data from the robotic compounding cycles from August 2017 to July 2018 were retrospectively obtained. Nine cycle specific parameters and five productivity indicators were analysed in each site. One-to-one differences between hospitals were evaluated. Next, a correlation analysis between cycle specific factors and productivity indicators was conducted; the factors presenting a highest correlation to automatic compounding time were used to develop a multiple regression model (afterwards validated) to predict the automatic compounding time. RESULTS A total of 2795 cycles (16367 preparations) were analysed. Automatic compounding time showed a relevant positive correlation (ǀrs|>0.40) with the number of preparations, number of vials and total volume per cycle. Therefore, these cycle specific parameters were chosen as independent variables for the mathematical model. Considering cycles lasting 40 minutes or less, predictability of the model was high for all three hospitals (R2:0.81; 0.79; 0.72). CONCLUSION Workflow differences have a remarkable incidence in the global productivity of the automated process. Total volume dosed for all preparations in a cycle is one of the variables with greater influence in automatic compounding time. Algorithms to predict automatic compounding time can be useful to help users in order to plan the cycles launched in KIRO Oncology.
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Affiliation(s)
- Ana C Riestra
- Pharmacy Department, Fundación Onkologikoa Fundazioa, Donostia-San Sebastián, Gipuzkoa, Spain
| | | | - Marion Jobard
- Service de Pharmacie Clinique, Hôpitaux Universitaires Paris Centre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - María J Tamés
- Pharmacy Department, Fundación Onkologikoa Fundazioa, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Ana M Marín
- Pharmacy Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Marie L Brandely-Piat
- Service de Pharmacie Clinique, Hôpitaux Universitaires Paris Centre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Rui Batista
- Service de Pharmacie Clinique, Hôpitaux Universitaires Paris Centre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gerardo Cajaraville
- Pharmacy Department, Fundación Onkologikoa Fundazioa, Donostia-San Sebastián, Gipuzkoa, Spain
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10
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Telleria N, García N, Grisaleña J, Algaba N, Bergareche E, Tamés MJ, Cajaraville G. Evaluation of the efficacy of a self-cleaning automated compounding system for the decontamination of cytotoxic drugs. J Oncol Pharm Pract 2020; 27:1343-1353. [PMID: 32854575 PMCID: PMC8438772 DOI: 10.1177/1078155220951866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction Low surface contamination levels of hazardous drugs in compounding areas can be used as indicators of exposure and efficacy of cleaning procedures. We report the efficacy results of the KIRO® Oncology self-cleaning automated compounding system for decontamination of cytotoxic drugs, assessed in an oncology health center using a sanitizing method and an alkaline method. Methods The study was conducted for six-days over a three-week period. A mixture with known levels of 5-fluorouracil, ifosfamide, cyclophosphamide, gemcitabine, etoposide, methotrexate, paclitaxel, docetaxel and carboplatin was added to the KIRO® Oncology’s compounding area surface before each self-cleaning method was used. Contamination levels were determined, with a surface wipe sampling kit, at the end of the self-cleaning process. Results Background surface contamination for quantified levels of cytotoxic drugs during routine use of KIRO® Oncology was below limit of quantification (<LOQ) for all drugs, except for carboplatin, which has a very low LOQ (0.2 ng/sample). The quantified drug levels detected on surface wipe samples after self-cleaning using both methods in the KIRO® Oncology’s compounding area surface sections were all <LOQ when spiking with 1 ng/cm2 (ten times the ‘safe’ reference value), except for carboplatin (alkaline method only), although its levels were still below the ‘safe’ reference value (0.1 ng/cm2). For surface contamination levels when spiking with 100 ng/cm2, both self-cleaning methods had decontamination efficacies >99.8% for all cytotoxic drugs analyzed. Conclusion This study provides evidence on the efficacy of the KIRO® Oncology automatic self-cleaning system for surface area decontamination during the preparation of cytotoxic drugs.
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Affiliation(s)
- Naiara Telleria
- Pharmacy Department, KIRO Grifols S.L., Arrasate, Gipuzkoa, Spain
| | - Nerea García
- Pharmacy Department, KIRO Grifols S.L., Arrasate, Gipuzkoa, Spain
| | - Jaione Grisaleña
- Pharmacy Department, KIRO Grifols S.L., Arrasate, Gipuzkoa, Spain
| | - Naiara Algaba
- Pharmacy Department, KIRO Grifols S.L., Arrasate, Gipuzkoa, Spain
| | - Eider Bergareche
- Pharmacy Department, KIRO Grifols S.L., Arrasate, Gipuzkoa, Spain
| | - María José Tamés
- Hospital Pharmacy Department, Fundación Onkologikoa, Donostia, Gipuzkoa, Spain
| | - Gerardo Cajaraville
- Hospital Pharmacy Department, Fundación Onkologikoa, Donostia, Gipuzkoa, Spain
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