自动化药物配制技术与工作流程解决方案在化疗药物制备中的应用：系统评价。
Automated compounding technology and workflow solutions for the preparation of chemotherapy: a systematic review.
机构信息
Mtech Access, Bicester, Oxfordshire, UK
Mtech Access, Bicester, Oxfordshire, UK.
出版信息
Eur J Hosp Pharm. 2020 Nov;27(6):330-336. doi: 10.1136/ejhpharm-2019-001948. Epub 2019 Aug 21.
OBJECTIVES
The current systematic review (SR) was undertaken to summarise the published literature reporting the clinical and economic value of automation for chemotherapy preparation management to include compounding workflow software and robotic compounding systems.
METHODS
Literature searches were conducted in MEDLINE, Embase and the Cochrane Library on 16 November 2017 to identify publications investigating chemotherapy compounding workflow software solutions used in a hospital pharmacy for the preparation of chemotherapy.
RESULTS
5175 publications were screened by title and abstract and 18 of 72 full publications screened were included. Grey literature searching identified an additional seven publications. The SR identified 25 publications relating to commercial technologies for compounding (Robotic compounding systems: APOTECAchemo (n=12), CytoCare (n=5) and RIVA (n=1); Workflow software: Cato (n=6) and Diana (n=1)). The studies demonstrate that compounding technologies improved accuracy in dose preparations and reduced dose errors compared with manual compounding. Comparable levels of contamination were reported for technologies compared with manual compounding. The compounding technologies were associated with reductions in annual costs compared with manual compounding, but the impact on compounding times was not consistent and was dependent on the type of compounding technology.
CONCLUSIONS
The published evidence suggests that the implementation of chemotherapy compounding automation solutions may reduce compounding errors and reduce costs; however, this is highly variable depending on the form of automation. In addition, the available evidence is heterogeneous, sparse and inconsistently reported. A key finding from the current SR is a 'call to action' to encourage pharmacists to publish data following implementation of chemotherapy compounding technologies in their hospital, which would allow for evidence-based recommendations on the benefits of chemotherapy compounding technologies.
目的
本系统评价（SR）旨在总结已发表的文献，报告化疗准备管理自动化的临床和经济价值，包括化合物工作流程软件和机器人化合物系统。
方法
2017 年 11 月 16 日，在 MEDLINE、Embase 和 Cochrane 图书馆中进行文献检索，以确定调查医院药房用于化疗制备的化疗化合物工作流程软件解决方案的出版物。
结果
通过标题和摘要筛选了 5175 篇出版物，从 72 篇全文筛选中筛选出 18 篇。灰色文献检索确定了另外 7 篇出版物。该 SR 确定了 25 篇与化合物商业技术相关的出版物（机器人化合物系统：APOTECAchemo（n=12）、CytoCare（n=5）和 RIVA（n=1）；工作流程软件：Cato（n=6）和 Diana（n=1））。这些研究表明，与手动化合物相比，化合物技术提高了剂量制备的准确性并减少了剂量误差。与手动化合物相比，报道的技术污染水平相当。与手动化合物相比，化合物技术与年度成本降低相关，但对化合物时间的影响不一致，且取决于化合物技术的类型。
结论
已发表的证据表明，实施化疗化合物自动化解决方案可能会减少化合物错误并降低成本；然而，这在很大程度上取决于自动化的形式。此外，可用证据具有异质性、稀疏性和不一致的报告。当前 SR 的一个重要发现是“呼吁采取行动”，鼓励药剂师在其医院实施化疗化合物技术后发布数据，从而可以对化疗化合物技术的益处提出基于证据的建议。
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