Scientific article
Open access

The safe handling of chemotherapy drugs in low- and middle-income countries: An overview of practices

Published inJournal of oncology pharmacy practice, vol. 28, no. 2, p. 410-420
Publication date2022-03
First online date2021-02-23

Introduction: The rising burden of cancer in low- and middle-income countries (LMICs) has led to substantial efforts to improve access to chemotherapy. The present study's objectives were to obtain an overview of the safe handling practices implemented in LMICs' healthcare facilities when dealing with chemotherapy drugs and to prioritize opportunities for improving them.

Methods: We conducted an online survey, from June 2018 to April 2019, among LMIC healthcare facilities dealing with chemotherapy drugs. Facilities were asked to self-assess their chemotherapy handling processes using Cyto-SAT, a self-assessment tool incorporating 134 items organized into 10 domains (management, personnel, logistics, prescription, preparation, administration, incident management, waste management, cleaning, and patient counselling). Data were recorded on an online platform (www.datapharma.ch/cyto-SAT).

Results: The survey enrolled 53 healthcare facilities (15 from low-income, 26 from lower-middle-income, and 12 from upper-middle-income countries). The median level of implementation of safe practices was 63% (Q1:39%-Q3:77%). Facilities in low-income countries (LICs) reported lower median levels of safe practices than middle-income countries (MICs) [LICs: 32% (Q1:24%-Q3:62%), Lower-MICs: 63% (Q1:49%-Q3:70%), Upper-MICs: 85% (Q1:77%-Q3:93%)]. The biggest differences between country categories were observed in the domains related to personnel, preparation processes, and incident management.

Conclusion: This overview of practices highlighted a large variability and major gaps in the safe handling of chemotherapy drugs in LMICs. Improvement strategies are needed to increase patient and staff safety and limit environmental contamination, especially in LICs. Safe handling programs should be part of continuing efforts to improve access to quality cancer drugs and should be integrated into national cancer control programs.

  • Safe handling practices
  • Chemotherapy
  • Cytotoxic drugs
  • Low- and middle-income countries
  • Oncology
  • Antineoplastic Agents
  • Developing Countries
  • Humans
  • Neoplasms / drug therapy
  • Pharmaceutical Preparations
  • Surveys and Questionnaires
Citation (ISO format)
VON GRUNIGEN, Sandrine, GEISSBUHLER, Antoine, BONNABRY, Pascal. The safe handling of chemotherapy drugs in low- and middle-income countries: An overview of practices. In: Journal of oncology pharmacy practice, 2022, vol. 28, n° 2, p. 410–420. doi: 10.1177/1078155221995539
Main files (1)
Article (Published version)
ISSN of the journal1078-1552

Technical informations

Creation12/10/2022 9:30:00 AM
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