Paper Analytic Device to Detect the Presence of Four Chemotherapy Drugs

Cost-effective track and trace technology for poor-quality chemotherapeutic pharmaceuticals in resource-limited countries: a review of the Chemotherapeutic Paper Analytical Device

Poor-quality medicines (substandard or counterfeit) can lead to treatment failure. There is a vast global imbalance in cancer treatment outcomes due to the difficulty of accessing quality chemotherapeutic products. Early diagnosis of cancer brings more hope for curative treatment of cancer and increases the demand for chemotherapeutic products. Consequently, it creates opportunities for unethical manufacturers and suppliers to develop substandard and/or counterfeit products. An ongoing review of cost-effective analytical methods is therefore paramount to tracking and tracing poor chemotherapeutic pharmaceutical products. Low- and middle-income country (LMIC) regulators lack safety equipment and standard operating procedures to handle chemotherapeutic products safely in the drug analysis laboratory and have limited capacity to perform post-marketing surveillance on these products. This review aimed to provide a compressive review of the Chemotherapeutic Paper Analytical Device (ChemoPAD). ChemoPAD is an important tool for quality screening of commonly used chemotherapeutic products in LMIC settings. It is an efficient, fast, simple, accessible, cost-effective, and transferable analytical method for verifying substandard and/or counterfeit chemotherapeutic products. Designed as a complete paper-based laboratory the size of a playing card, the ChemoPAD provides a promising solution for healthcare providers, patients, and other parties involved in post-marketing surveillance of chemotherapeutic products. Thus, in the near future, scientists could probably witness the use of the ChemoPAD technology platform to trace and track substandard and/or counterfeit chemotherapeutic products.

Chemotherapy supply chain management, safe-handling and disposal in Ethiopia: the case of Tikur Anbessa specialized hospital

Optimal chemotherapy management is substandard in low and middle-income countries. We aimed to identify major gaps to design interventional strategies for improved chemotherapy management at Tikur Anbessa Specialized Hospital (TASH), Ethiopia. This study was conducted using an observational checklist, open-ended questions, record review, and key informant interviews of department heads and focal persons at TASH. Findings were categorized into specific themes that developed. Chemotherapy represented 60.2% of the hospital medication budget. Drug utilization was quantified via monthly consumption documentation and forecasting. However, unreliable data resulted in frequent stockouts (unavailability of the item when it is needed) of chemotherapy with only 67.8% availability. Thirteen healthcare personnel (9 nurses, 2 pharmacists and 2 hospital cleaners) were interviewed: all clinical staff but neither of hospital cleaners believed that they were at risk of hazardous agents. Challenges identified included inadequate and frequent stockouts (unavailability of the item when it is needed) of personal protective equipment, lack of standardized guidelines for chemotherapy handling, admixture, and disposal, lack of designated preparation rooms, and lack of training. All nine nurses handled chemotherapy admixtures despite only two nurses previously receiving in-service training. Most of the participants had never witnessed the disposal of anticancer drugs. Prompted by the results of this study, a dialogue was initiated among members of TASH, the American Cancer Society and the University of North Carolina to implement action-oriented projects to address the gaps identified at TASH. These gaps directly and indirectly affect care and treatment outcomes of patients at a large cancer center. Collaborations with well-resourced centers are potential models for improving chemotherapy management.