https://doi.org/10.4081/scenario.2023.557

A robotic system for chemotherapy preparations: A literature review

Vol. 40 No. 2 (2023)
Published: 19 July 2023
Apotecachemo, compounding robot chemotherapy, robotic antineoplastic preparation
Abstract Views: 692
PDF (Italiano): 117
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Gennaro Laus
Coordinatore Infermieristico, Farmacia Umaca, IRCCS CROB Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy.

Introduction: the most critical phase of the chemotherapy preparation process is preparation, in which both the maximum level of exposure for the operator and the greatest number of possible errors are recorded. Today there are robotic systems available that can replicate what the operator does manually.

Materials and Methods: a literature review was performed between October and November 2022, consulting the Medline (PubMed interface), Cochrane Library, and Google Scholar databases. The limits applied to the search for articles were: Italian/English language and publication in the last 10 years. The question we tried to answer was “What is the effectiveness, safety, organizational and economic impact of the robotic system compared to the manual system?”.

Results: the initial literature search identified 137 relevant articles for the review, subsequently excluding 12 because they were duplicates, 29 because they in French/Portuguese/Spanish and published prior to October 2012, 69 articles because they contained different objectives. Therefore, 27 articles were considered for the purposes of this review.

Discussion: the data collected demonstrate how the efficacy, accuracy and precision of the chemotherapy preparations provided through the use of robotic systems are greater than manual preparations. The robotic system ensures greater safety for operators and patients. The comparison of the two preparation methods showed that the contamination of the preparations is lower in the robotic systems. The results of the improvement of the workflow are contrasting. From an economic point of view, it could lead to a reduction in costs.

Conclusions: in order to be able to support decisions relating to the introduction of robotic systems for the preparation of chemotherapy in all contexts, further comparative studies would be very useful and desirable, especially in the Italian context.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
McDiarmid MA, Oliver MS, Roth TS, et al. Chromosome 5 and 7 abnormalities in oncology personnel handling anticancer drugs. J Occup Environ Med 2010;52:1028-34.
McDiarmid MA, Rogers B, Oliver MS. Chromosomal effects of non-alkylating drug exposure in oncology personnel. Environ Mol Mutagen 2014;55:369-74.
Nassan FL, Chavarro JE, Johnson CY, et al. Prepregnancy handling of antineoplastic drugs and risk of miscarriage in female nurses. Ann Epidemiol 2021;53:95-102.e2.
Suspiro A, Prista J. Biomarkers of occupational exposure do anticancer agents: a minireview. Toxicol Lett 2011;207:42-52.
Gianfredi V, Salvatori T, Nucci D, et al. Genotoxic risk in nurses handling antiblastic drugs: systematic review of literature and meta-analysis. Recenti Prog Med 2017;108:511-20.
Connor TH, McDiarmid MA. Preventing occupational exposures to antineoplastic drugs in health care settings. CA Cancer J Clin 2006;56:354-65.
Grave CU, McGovern PM, Alexander B, et al. Occupational Exposure to Antineoplastic Agent. Workplace Health Saf 2017;65:9-20.
Forcisi S, Caporossi L, Cavarra M, Papaleo B. Study of the application of the guidelines for the handling of citotoxic drugs in some health facilities. Prof Inferm 2015;68:157-62.
Gurusamy KS, Best LMJ, Tanguay C, et al. Closed‐system drug‐transfer devices plus safe handling of hazardous drugs versus safe handling alone for reducing exposure to infusional hazardous drugs in healthcare staff. Cochrane Database Syst Rev 2018;2018:CD012860. Published online on 2018 Mar 27.
Rinehart J, Jorgenson JA. Considerations for handling monoclonal antibodies. Biologics 2015;12:6.
Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009;62:1006-12.
Batson S, Mitchell SA, Lau D, et al. Automated compounding technology and workflow solutions for the preparation of chemotherapy: a systematic review. Eur J Hosp Pharm 2020;27:330-36.
Iwamoto T, Morikawa T, Hioki M. Performance evaluation of the compounding robot, APOTECAchemo, for injectable anticancer drugs in a Japanese hospital. J Pharm Health Care Sci 2017;3.
Seger AC, Churchill WW, Keohane CA. Impact of robotic antineoplastic preparation on safety, workflow, and costs. J Oncol Pract 2012;8:344-9.
Palma E, Bufarini C. Robotized compounding of oncology drugs in a hospital pharmacy. Int J Pharm Compd 2014;18:358-64.
Sanogo S, Silimbani P, Gaggeri R, Masini C. Stability of calcium levofolinate reconstituted in syringes and diluted in NaCl 0.9% and glucose 5% polyolefin/polyamide infusion bags. J Oncol Pharm Pract 2020;27. Published online on April 16, 2020.
Yaniv AW, Knoer SJ. Implementation of an i.v.- compounding robot in a hospital-based cancer center pharmacy. Am J Health Syst Pharm 2013;70:2030-7.
Schieri R, Masini C, Groeneveld G. Environmental contamination by cyclophosphamide preparation: Comparison of conventional manual production in biological safety cabinet and robot-assisted production by APOTECAchemo. J Oncol Pharm Practice 2016;22:37-45.
Werumeus Buning A, Geersing TH, Crul M. The assessment of environmental and external cross-contamination in preparing ready-to-administer cytotoxic drugs: a comparison between a robotic system and conventional manual production. Int J Pharm Pract 2020;28:66-74.
Krämer I, Federici M, Schierl R. Environmental and Product Contamination during the Preparation of Antineoplastic Drugs with Robotic Systems. Published by De Gruyter, July 26th, 2018. J Pharm Technol Hosp Pharm.
Hao ML, Wang T, Zhu JQ, et al. 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.
Krämer I, Federici M, Kaiser V, Thiesen J. Media-fill simulation tests in manual and robotic aseptic preparation of injection solutions in syringes. J Oncol Pharm Pract 2016;22:195-204.
Geersing TH, Klous MG, Franssen EJF, et al. Robotic compounding versus manual compounding of chemotherapy: Comparing dosing accuracy and precision. Eur J Pharm Sci 2020;155:105536. Epub 2020 Aug 30.
Krämer I, Federici M. Implementation and microbiological stability of dose-banded ganciclovir infusion bags prepared in series by a robotic system. Eur J Hosp Pharm 2020;27:209-15.
Schoening T, Artes A, Ehmann M, et al. Semiautomated aseptic preparation of patient-individual antineoplastic intravenous solutions: first experiences in a German hospital pharmacy. Eur J Hosp Pharm. BMJ J 2016;23.
Geersing TH, Franssen EJF, Pilesi F, Crul M. Microbiological performance of a robotic system for aseptic compounding of cytostatic drugs. Eur J Pharm Sci 2019;130:181-5.
Sessink PJM, Leclerq GM, Wouters DM, et al. Environmental contamination, product contamination and workers exposure using a robotic system for antineoplastic drug preparation. J Oncol Pharm Pract 2015;21:118-27.
Jobard M, Brandely-Piat ML, Chast F, Batista R. Qualification of a chemotherapy-compounding robot. J Oncol Pharm Pract 2020;26:312-24.
Heloury J, Bouguèon G, Deljehier T, et al. Automation of Aseptic Sterile Preparation: Risk Analysis and Productivity Comparison with Manual Process. Pharm Technol Hosp Pharm, Published online on April 4th, 2019.
Milibari L, Cotugno M, Belisle C, et al. Single Center Experience with Robot Technologies for Sterile Compounding: A Retrospective Review. Int J Pharm Compd 2020;24:346-51.
Nurgat Z, Faris D, Mominah M, et al. A three-year study of a first-generation chemotherapy-compounding robot. Am J Health Syst Pharm 2015;72:1036-45.
Deljehier T, Bouguéon G, Heloury J, et al. Simulation program of a cytotoxic compounding robot for monoclonal antibodies and anti-infectious sterile drug preparation. J Oncol Pharm Pract 2019;25:1873-90.
Yaniv W. Robotic i.v. medication compounding: Recommendations from the international community of APOTECAchemo users. Am J Health Syst Pharm 2017;74:e40-e46.
Capilli M, Enrico F, Federici M, Comandone T. Increasing pharmacy productivity and reducing medication turnaround times in an Italian comprehensive cancer center by implementing robotic chemotherapy drugs compounding. J Oncol Pharm Pract 2022;28:353-61.
Baan SD, Geersing TH, Crul M, et al. An economic evaluation of vial sharing of expensive drugs in automated compounding. Int J Clin Pharm 2022;44:673-9.
Unluturk MS, Tamer O, Utku S. A robotic system to prepare IV solutions. Int J Med Inform 2018;119:61-9.
Liu H, Zou L, Song Y, Yan J. Cost analysis of implementing a vial-sharing strategy for chemotherapy drugs using intelligent dispensing robots in a tertiary Chinese hospital in Sichuan. Front Public Health 2022;10:936686.
Bhakta SB, Colavecchia AC, Coffey W, et al. Implementation and evaluation of a sterile compounding robot in a satellite oncology pharmacy. Am J Health Syst Pharm 2018;75:S51-S57.

How to Cite

Laus, G. (2023). A robotic system for chemotherapy preparations: A literature review. Scenario® - Il Nursing Nella Sopravvivenza, 40(2). https://doi.org/10.4081/scenario.2023.557
Copyright (c) 2023 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Aniarti has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.