Adaptation of a pharmaceutical technology activity to COVID-19: experiment in a peripheral hospital center

Introduction
The cytotoxic preparation unit performs an average of 76 chemotherapies per day. In the context of the COVID-19 epidemic, new treatment recommendations have been published by various learned companies and expert groups. Their objective is to reduce the number and duration of day hospital stays (DH). This work highlights part of the adaptation of teams to the health crisis.

Material and method
The study period runs from mid-March to the end of May 2020. A review of the literature was performed. Then, a consultation with oncologists and hematologists physicians took place. The published recommendations let to target protocols to space out and/or cancel treatments. The protocols were created on the prescription assistance software.
Secondly, closer collaboration with home care (HC) permitted to promote patient cares at home.

Results
Protocol modifications were carried out: this concerns 5 protocols including 16 patients.
The total number of canceled cures is 48, an average of 19 cures per month over a 2.5 month period. In addition, before the epidemic, the number of patients treated with HC was 13 compared to 19 patients at the end of the study.

Discussion – Conclusion
Our chemotherapy activity, steadily increasing, declined slightly during the study. This decrease is insignificant in our region less affected by the health crisis. The total of canceled treatments was not quantified because this data was difficult to assess in retrospect. The number of additional patients supported by HC is small, but it has created momentum.
The decrease in the number of cures made it possible to lower the passage of patients in DH, reducing the risk of contamination in this fragile patient population.

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