Feedback on 5 months of use of a robotized production system in the Cytotoxic Reconstitution Unit

Introduction
Due to a constant increase in activity, a robot for the automated production of anticancer chemotherapies was installed in the unit. Operating continuously since January 2022, it allows the production of 10 molecules in standard doses.
The objective of this work is to assess the productivity during the 5 months of use.

Materials and methods
The Pharmoduct^® robot of the Dedalus laboratory allows the production of standard doses from a multidose bag of pure product (undiluted). It can produce up to 13 preparations per campaign. It is composed of two carousels: the 1st carousel is used to place the vials for the multidose bag, the 2nd is used to place the containers for the final preparations. The control of the preparations is done by gravimetry. The campaigns are programmed directly on the robot software, then recorded on the Chimio® software. All the standard preparations are made with the robot.
The data collection was made from the Chimio^® software and the batch records of the campaigns from January 1, 2022 to May 31, 2022. The following data were collected: the total number of preparations, the number of robotized preparations, the number of standard doses dispensed, the number of standard doses destroyed and the percentage of standard dose prescriptions.

Results
During the period studied, 27,015 preparations were made, including 3,379 by robot, i.e. 12.5% of our production. 3,087 standard preparations were dispensed, i.e. an average of 11.3% of daily dispensations (2.8-18.8% min-max). 6.7% of the preparations produced were destroyed. There are two causes of destruction: non-compliant gravimetric control or preparation not used before its expiration date. For the 10 molecules concerned, an average of 61% of the prescriptions are in standard doses (33-88% min-max). Out of 106 days, the robot was used for 74.5 days. The inactivity was due to breakdowns or lack of personnel. Improvements have been made on breakdowns to avoid their recurrence.

Discussion/Conclusion
After a period of qualification and fine-tuning of various technical problems, the productivity of the robot has improved considerably, reaching 60 preparations/day over 6 hours of effective production. With experience, a better control of the consumption of standard preparations allows us to have less destruction due to expiration. The addition of 4 more molecules should allow us to achieve 25% of the total production in a robotized way. Supporting doctors in prescribing standard doses should also enable us to produce fewer nominative doses.

See the poster