Automated preparation of chemotherapy: Quality improvement and economic sustainability

Masini, Carla; Nanni, Oriana; Antaridi, Sara; Gallegati, Davide; Marri, M; Paolucci, D; Minguzzi, Martina; Altini, Mattia

doi:10.2146/ajhp130489

Cited by 49 publications

(68 citation statements)

References 16 publications

(14 reference statements)

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“…Seger et al 7 showed that mean drug preparation time increased by 47% on using a fully automated robotic approach compared with manual compounding. Even if we also assessed a slightly shorter time consumption for a comparable manual process (about 66 min), we see several advantages in using a robotic device as already described recently:8 The assessed time consumption refers to one person working at the device, whereas the manual volumetric-based preparation is strictly bound to two persons for safety reasons (number of materials in the working area, in process-cross-checks). Staff can take care of preprocessing and postprocessing steps for recent and future runs while the production run is being performed automatically.…”

Section: Discussionmentioning

confidence: 96%

Semiautomated aseptic preparation of patient-individual antineoplastic intravenous solutions: first experiences in a German hospital pharmacy

et al. 2015

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Objectives In 2013, the PharmaHelp device was introduced to daily patient care at the University Hospital of Heidelberg in order to improve process and staff safety and health. It is a semiautomated device located in a safety workbench for aseptic preparation with weight-and-visual-supported process check as well as radio-frequency identification of bags and vials. Methods After qualification and a training period, several high-admixture-volume drugs were chosen stepwise to be prepared by the device. During a reporting period of 6 months, the number of processed production runs and produced bags were assessed as well as the productivity per hour of the device based on the processed admixing volume and time consumption for manual preprocessing and postprocessing steps.

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Section: Discussionmentioning

confidence: 96%

Semiautomated aseptic preparation of patient-individual antineoplastic intravenous solutions: first experiences in a German hospital pharmacy

et al. 2015

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“…From January to August 2015, the median rate of absolute dose error more than 5% was 0.7% (range: 0.0–1.9%) for each month in the robotic preparation (total of 3,192 preparations for 34 anticancer drugs) in practice. There is one report comparing the performance between robotic preparation using APOTECAchemo and manual preparation, showing that both preparations were accurate and precise [12]. The range of percent dose error (accuracy) and standard deviation (precision) for robotic preparation were from −3.71 to 0.42% and from 0.57 to 1.92%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…At present, the compounding robot APOTECAchemo (Loccioni Humancare, Italy) has been used in 51 hospitals in 14 countries [11, 12]. Robotic preparation leads to solve the problem of manual preparation, such as exposure or contact of hazardous drugs, stress of preparation, human error of preparation, and weakness of traceability for preparation error.…”

Section: Introductionmentioning

confidence: 99%

Performance evaluation of the compounding robot, APOTECAchemo, for injectable anticancer drugs in a Japanese hospital

Iwamoto

Morikawa

Hioki

et al. 2017

J Pharm Health Care Sci

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BackgroundThe accuracy, safety and feasibility of, the compounding robot APOTECAchemo were evaluated in the clinical practice of Japan.MethodsAccuracy and precision of robotic preparations by APOTECAchemo was evaluated in 20 preparations of fluorouracil (FU) and cyclophosphamide (CPA) infusions by four pharmacists. Environmental and product contaminations with FU and CPA were evaluated by wipe testing. Robotic performance was compared with manual preparation in a biological safety cabinet. The number of robotic products, total compounding time and total pre-reconstitution time of lyophilized drugs between January 1, 2014 to December 31, 2015 were investigated.ResultsRobotic preparation resulted more accurate and precise (mean absolute dose error and coefficient of variation were 0.83 and 1.04% for FU and 0.52 and 0.59% for CPA) than those of manual preparation (respective values were 1.20 and 1.46% for FU and 1.70 and 2.20% for CPA). Drug residue was not detected from any of the prepared infusion bags with the robotic preparation, whereas FU was detected in two of four analyzed infusion bags with manual preparation. Average total time to make single anticancer drug preparation (compounding plus reconstitution of lyophilized drugs) was 6.11 min in the second half of 2015. During the study period, the highest percentage of production covered by APOTECAchemo was 70.4% of the total inpatient pharmacy activity.ConclusionRobotic preparation using APOTECAchemo should give substantial advantages in drug compounding for accuracy and safety and was able to be successfully worked in Mie university hospital.

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“…These robots reduce the occupational exposure of health care workers during the compounding process, yet like the other options, are not perfect, most of all because they require human staff to load and clean and most of the time they do not give a quick performance. They are generally more expensive and do not substantially reduce serious medication errors [29, 30]. …”

Section: Primary Engineering Controlmentioning

confidence: 99%

Oncology pharmacy units: a safety policy for handling hazardous drugs and related waste in low- and middle-income African countries—Angolan experience

Conceição

Bernardo

Lopes

et al. 2015

ecancer

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In African countries, higher rates of late-stage cancers at the time of first diagnosis are a reality. In this context, hazardous drugs (HDs), such as chemotherapy, play an important role and have immense benefits for patients’ treatment.HDs should be handled under specific conditions. At least a class 5 environment primary engineering control (PEC), physically located in an appropriate buffer area, is mandatory for sterile HDs compounding, as well as administrative control, personal protective equipment, work practices and other engineering and environmental controls, in order to protect the environment, patient, and worker.The aim of this study is to describe the Angolan experience regarding the development of oncology pharmacy units and discuss international evidence-based guidelines on handling HDs and related waste. Measures to incorporate modern and economical solutions to upgrade or build adequate and safe facilities and staff training, in order to comply with international guidelines in this area, are crucial tasks for African countries of low and middle income.

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Automated preparation of chemotherapy: Quality improvement and economic sustainability

Abstract: Both the automated and manual procedures for preparing antineoplastic preparations proved to be accurate and precise. The automated procedure resulted in substantial advantages in terms of quality maintenance standards and risk lowering.

Cited by 49 publications

References 16 publications

Semiautomated aseptic preparation of patient-individual antineoplastic intravenous solutions: first experiences in a German hospital pharmacy

Semiautomated aseptic preparation of patient-individual antineoplastic intravenous solutions: first experiences in a German hospital pharmacy

Performance evaluation of the compounding robot, APOTECAchemo, for injectable anticancer drugs in a Japanese hospital

Oncology pharmacy units: a safety policy for handling hazardous drugs and related waste in low- and middle-income African countries—Angolan experience

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