Knowledge, attitudes, and practices among oncology pharmacists on cytotoxic drug reconstitution in Sri Lanka: A cross-sectional study.

Abstract

IntroductionCancer is a significant global health challenge, often managed through cytotoxic drugs (CDs). CDs are inherently hazardous and can disrupt both cancerous and healthy cells. Cytotoxic reconstitution requires specialized training to ensure both the quality of the medication and the safety of the healthcare professionals who handle CDs.MethodsA descriptive cross-sectional survey was conducted among 50 oncology pharmacists working across 22 government hospitals in Sri Lanka, using a self-administered questionnaire to assess the knowledge, attitudes, and practices on CDs reconstitution.ResultsMost participants were male (98.00%). More than 74.00% of the pharmacists identified the facilities that should be available within the cytotoxic reconstitution unit (CRU). A majority of participants had strong concerns over the potential risks of CDs; carcinogenicity (86.00%), teratogenicity (92.00%), reproductive toxicity (78.00%), and mutagenicity (68.00%). All the participants had positive attitudes towards using personal protective equipment, cytotoxic isolators, and regular cleaning. The majority (91.84%) of the participants had concerns that exposure to chemotherapy is a serious workplace issue. Formal training on CDs handling was received by 86.00% of the pharmacists. More than 85.00% of the participants in this study reported using water and chemical-proof aprons, safety goggles, half-face double-way respiratory cartridges, and powder-free surgical gloves. Over 85% of participants adhered to proper cytotoxic waste disposal protocols.ConclusionParticipants demonstrated good attitudes toward minimizing occupational exposure to the CDs and were proactive in updating their knowledge via training programmes. This study recommends the enforcement of standard guidelines for handling CDs, periodical training, and educational programmes for oncology pharmacists.