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      Oncology pharmacy units: a safety policy for handling hazardous drugs and related waste in low- and middle-income African countries—Angolan experience

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          Abstract

          In African countries, higher rates of late-stage cancers at the time of first diagnosis are a reality. In this context, hazardous drugs (HDs), such as chemotherapy, play an important role and have immense benefits for patients’ treatment.

          HDs should be handled under specific conditions. At least a class 5 environment primary engineering control (PEC), physically located in an appropriate buffer area, is mandatory for sterile HDs compounding, as well as administrative control, personal protective equipment, work practices and other engineering and environmental controls, in order to protect the environment, patient, and worker.

          The aim of this study is to describe the Angolan experience regarding the development of oncology pharmacy units and discuss international evidence-based guidelines on handling HDs and related waste. Measures to incorporate modern and economical solutions to upgrade or build adequate and safe facilities and staff training, in order to comply with international guidelines in this area, are crucial tasks for African countries of low and middle income.

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          Most cited references34

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          Mutagenicity in urine of nurses handling cytostatic drugs.

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            The Economic Burden of Cancers on Indian Households

            We assessed the burden of cancer on households’ out-of-pocket health spending, non-medical consumption, workforce participation, and debt and asset sales using data from a nationally representative health and morbidity survey in India for 2004 of nearly 74 thousand households. Propensity scores were used to match households containing a member diagnosed with cancer (i.e. cancer-affected households) to households with similar socioeconomic and demographic characteristics (controls). Our estimates are based on data from 1,645 households chosen through matching. Cancer-affected households experienced higher levels of outpatient visits and hospital admissions and increased out-of-pocket health expenditures per member, relative to controls. Cancer-affected households spent between Indian Rupees (INR) 66 and INR 85 more per member on healthcare over a 15-day reference period, than controls and additional expenditures (per member) incurred on inpatient care by cancer-affected households annually is equivalent to 36% to 44% of annual household expenditures of matched controls. Members without cancer in cancer-affected households used less health-care and spent less on healthcare. Overall, adult workforce participation rates were lower by between 2.4 and 3.2 percentage points compared to controls; whereas workforce participation rates among adult members without cancer were higher than in control households. Cancer-affected households also had significantly higher rates of borrowing and asset sales for financing outpatient care that were 3.3% to 4.0% higher compared to control households; and even higher for inpatient care.
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              ASHP Guidelines on Handling Hazardous Drugs

              (2006)
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                Author and article information

                Journal
                Ecancermedicalscience
                Ecancermedicalscience
                ecancermedicalscience
                ecancermedicalscience
                Cancer Intelligence
                1754-6605
                2015
                01 October 2015
                : 9
                : 575
                Affiliations
                [1 ]Cancer Unit of Girassol Clinic, Comandante Gika 225, Luanda, Angola
                [2 ]Pharmacy Department of Portuguese Institute of Oncology, Rua Dr António Bernardino de Almeida – 4200–072, Porto, Portugal
                [3 ]Cancer Unit of Sagrada Esperança Clinic, Av Murtala Mohammed, Luanda, Angola
                [4 ]Angolan Institute of Cancer Control, Rua Amilcar Cabral, Luanda, Angola
                [5 ]Nurse Department of Portuguese Institute of Oncology, Rua Dr António Bernardino de Almeida – 4200–072, Porto, Portugal
                [6 ]ONCOCIR - Education and Care in Oncology, Marçal, Luanda, Angola
                [7 ]Experimental Pathology and Therapeutics Group and Surgical Oncology Department, Portuguese Institute of Oncology, Rua Dr António Bernardino de Almeida – 4200–072, Porto, Portugal
                [* ]These authors equally contributed to this study.
                Author notes
                Correspondence to: Lúcio Lara Santos, llarasantos@ 123456gmail.com
                Article
                can-9-575
                10.3332/ecancer.2015.575
                4631569
                2affe707-00a8-4a82-8c29-1dea5757633c
                © the authors; licensee ecancermedicalscience.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 June 2015
                Categories
                Research

                Oncology & Radiotherapy
                angola,chemotherapy,hazardous drugs,low- and middle-income industries,oncology pharmacy units

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