Un sistema robotizzato per le preparazioni chemioterapiche: una revisione della letteratura

Pubblicato: 19 luglio 2023
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Introduzione: la fase più critica del processo di allestimento dei chemioterapici è la preparazione, in cui si registra sia il massimo livello di esposizione per l’operatore che il maggior numero di possibili errori. Oggi sono disponibili sistemi robotizzati che possono replicare quello che l’operatore esegue manualmente.

Materiali e Metodi: è stata eseguita una revisione della letteratura tra Ottobre e Novembre 2022, consultando le banche dati Medline (interfaccia PubMed), Cochrane Library e Google Scholar. I limiti applicati per la ricerca degli articoli sono stati: lingua italiana/inglese e pubblicazione negli ultimi 10 anni. Il quesito a cui si è cercato di rispondere è stato “Qual è l’efficacia, la sicurezza, l’impatto organizzativo ed economico del sistema robotizzato rispetto al sistema manuale?”.

Risultati: la ricerca bibliografica iniziale ha permesso di identificare 137 articoli rilevanti per la revisione, in seguito esclusi 12 perchè duplicati, 29 perchè in lingua francese/portoghese/spagnolo e antecedenti a Ottobre 2012, 69 articoli perchè contenenti obiettivi diversi. Sono stati dunque considerati ai fini della presente revisione 27 articoli.

Discussione: i dati raccolti dimostrano come l’efficacia, l’accuratezza e la precisione delle preparazioni di chemioterapici fornite tramite l’utilizzo dei sistemi robotizzati siano maggiori rispetto le preparazioni manuali. Il sistema robotizzato assicura maggiore sicurezza agli operatori e pazienti. Il confronto dei due metodi di preparazione ha evidenziato che la contaminazione delle preparazioni è inferiore nei sistemi robotizzati. Contrastanti sono i risultati sul miglioramento del workflow. Dal punto di vista economico potrebbe portare ad una riduzione dei costi.

Conclusioni: al fine di poter supportare decisioni relative all’introduzione di sistemi robotizzati per la preparazione dei chemioterapici in tutti i contesti sarebbero molto utili e auspicabili ulteriori studi di confronto, soprattutto nel contesto italiano.

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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.

Come citare

Laus, G. (2023). Un sistema robotizzato per le preparazioni chemioterapiche: una revisione della letteratura. Scenario® - Il Nursing Nella Sopravvivenza, 40(2). https://doi.org/10.4081/scenario.2023.557