College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea.
College of Pharmacy, Dankook University, Cheonan 31116, Republic of Korea.
Medicina (Kaunas). 2023 Feb 22;59(3):431. doi: 10.3390/medicina59030431.
: With the increased prevalence of patients with cancer, the demand for preparing cytotoxic drugs was increased by health-system pharmacists. To reduce the workload and contamination of work areas in pharmacies, compounding robots preparing cytotoxic drugs have been introduced, and the use of the robots has been expanded in recent years. As reports on the comprehensive and quantitative evaluation of compounding robots remain lacking, a systematic review and meta-analysis were conducted to provide descriptive and quantitative evaluations of the accuracy of preparing injectable cytotoxic drugs. : A systematic review and meta-analysis were conducted using published studies up to 2020. To identify eligible studies, PubMed, EMBASE, and Cochrane Library were used. All studies reporting the outcomes relevant to drug-compounding robots such as accuracy, safety, and drug contamination were included. Outcomes from included studies were descriptively summarized. Drug contamination by the robot was quantitatively analyzed using the odds ratio (OR) with a 95% confidence interval (CI). The risk of bias was assessed using the Risk of Bias Assessment tool for Non-randomized Studies (RoBANS). : A total of 14 compounding robot studies were eligible for review and 4 studies were included in the meta-analysis. Robotic compounding showed failure rates of 0.9-16.75%, while the accuracy range was set at 5%. Two studies reported that robotic compounding needed more time than manual compounding, two reported that robotic compounding needed less time, and one just reported preparation time without a control group. In a meta-analysis regarding the contamination of the compounding area, manual compounding was associated with lower contamination, although the result was not statistically significant (OR 4.251, 95% CI 0.439-51.772). For the contamination of infusion bags, the robot was associated with lower contamination (OR 0.176, 95% CI 0.084-0.365). : Robotic compounding showed better accuracy than manual compounding and, without control groups, showed a high accuracy rate and also reduced the risk of drug contamination and compounding workload. The preparation time of the robot was not consistent because the type of robot and introduced system were different. In conclusion, robotic compounding showed mixed results compared to the manual compounding of drugs, so the system should be introduced considering the risks and benefits of robots.
: 随着癌症患者的增多，医疗机构药剂师对细胞毒性药物的需求量也随之增加。为了减少药剂科的工作量和工作区域的污染，已经引入了配制细胞毒性药物的混合机器人，并且近年来其使用范围不断扩大。由于缺乏关于混合机器人全面和定量评估的报告，因此进行了系统评价和荟萃分析，以对注射用细胞毒性药物的配制准确性进行描述性和定量评估。 : 系统评价和荟萃分析使用截至 2020 年发表的研究进行。为了确定合格的研究，使用了 PubMed、EMBASE 和 Cochrane Library。纳入了所有报告与药物混合机器人相关的结果的研究，如准确性、安全性和药物污染。对纳入研究的结果进行了描述性总结。使用优势比（OR）及其 95%置信区间（CI）对机器人引起的药物污染进行了定量分析。使用非随机研究的风险偏倚评估工具（RoBANS）评估了风险偏倚。 : 共有 14 项混合机器人研究符合审查标准，其中 4 项研究纳入荟萃分析。机器人混合的失败率为 0.9-16.75%，而准确性范围设定为 5%。两项研究报告称，机器人混合比手动混合需要更多的时间，两项研究报告称，机器人混合需要更少的时间，一项研究只是报告了没有对照组的准备时间。在一项关于混合区域污染的荟萃分析中，手动混合的污染程度较低，尽管结果无统计学意义（OR 4.251，95% CI 0.439-51.772）。对于输液袋的污染，机器人混合的污染程度较低（OR 0.176，95% CI 0.084-0.365）。 : 机器人混合的准确性优于手动混合，并且在没有对照组的情况下，具有很高的准确性，同时还降低了药物污染和混合工作量的风险。由于机器人的类型和引入的系统不同，因此机器人的准备时间并不一致。总之，与手动混合药物相比，机器人混合的结果好坏参半，因此应在考虑机器人风险和收益的情况下引入该系统。
