Category: Professional Posters
Purpose: Pharmacists who handle antineoplastic drugs are at high risk of occupational hazards. Therefore, we developed an automated robotic system, DARWIN-Chemo®, with Yaskawa Electric Corporation and Nikka Micron Co., Ltd. After drug preparation, DARWIN-Chemo® could wash off drug residues from infusion bag surfaces with ozonated water. DARWIN-Chemo® could prepare up to 20 prescriptions of drugs continuously for several hours, without being monitored by an operator. In this study, we evaluated the accuracy, site contamination, and washing performance of DARWIN-Chemo®. We also assessed the overnight preparation of drugs by DARWIN-Chemo® in our hospital.
Methods: The accuracy of drug preparation by DARWIN-Chemo® and a pharmacist were compared. Both DARWIN-Chemo® and the pharmacist prepared five formulations of 5-fluorouracil (5-FU) in 100 mL of saline. The weight of the mixed drugs prepared using DARWIN-Chemo® was compared with that of the drugs prepared by the pharmacist. The accuracy of each drug preparation was calculated in terms of percentage relative error. For site contamination test, cyclophosphamide (CPA) was continuously added to 50 bags of 100 mL saline solution and then identified in 25 locations inside an isolator. The remaining CPA was collected using the sampling sheet method. The washing performance was tested by washing off 5-FU from the surface of the infusion bag. Twenty specimens of 5-FU that showed adherence to the surface of the infusion bag were removed with ozonated water. Any residual 5-FU was removed by wiping. We also evaluated the usefulness of overnight preparation of antineoplastic drugs using DARWIN-Chemo® and collected data between April 2018 and March 2019. The average number and operation time of antineoplastic drug preparations during the day (8 am–4 pm) and overnight (0 am–8 am) were compared between the 1st and 12th month of the operational year.
Results: The average weight error ratios for DARWIN-Chemo® and the pharmacist were −0.62% and 2.69%, respectively. CPA contamination was confirmed at the syringe drive unit of the main body; the floor surface, right-arm claw, and stirrer showed contamination ≥1 ng/cm2. Pollution was confirmed for two 5-FU specimens, with a removal rate of ≥99.9%. DARWIN-Chemo® was used for 312 days in a 12-month period. The total number of antineoplastic drug preparations was 17,567, of which 5,743 (32.7%) were prepared by DARWIN-Chemo®. Of the 5,743 preparations, 1,994 (34.7%) were overnight preparations. Between the 1st and 12th month of the operational year, the average percentage of antineoplastic drugs prepared by DARWIN-Chemo® increased from 19.1% to 38.1%, and the average number of overnight preparations increased from 3.2 to 7.2.
Conclusion: Our study showed that the preparation accuracy and cleaning performance of DARWIN-Chemo® were acceptable. Overnight preparation of antineoplastic drugs by DARWIN-Chemo® substantially increased the number of preparations. Thus, DARWIN-Chemo® is suggested for practical use to reduce the burden on pharmacists and their exposure to antineoplastic drugs.