Cochrane · systematic review · CD012860
Closed‐system drug‐transfer devices plus safe handling of hazardous drugs versus safe handling alone for reducing exposure to infusional hazardous drugs in healthcare staff
Gurusamy, KS, Best, LMJ, Tanguay, C, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
WorkAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
22
current version
GRADE rated
16
No studies
6
Included studies
NR
No studies 6 · 27.3%Ungraded 0 · 0%Very low 16 · 72.7%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Closed‐system transfer device plus safe handling versus safe handling alone for reducing healthcare staff exposure to infusional hazardous drugs: exposure and surface contamination
Population: healthcare staff who handle infusional hazardous drugs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cyclophosphamide alone Closed‐system transfer device plus safe handling vs safe handling alone | RR 0.83 [0.46, 1.52] | NR | Very low Downgraded: risk of bias, imprecision |
Cyclophosphamide or ifosfamide Closed‐system transfer device plus safe handling vs safe handling alone | RR 0.09 [0, 2.79] | NR | Very low Downgraded: risk of bias, imprecision |
Cyclophosphamide, ifosfamide, or gemcitabine Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Other measures of exposure Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | No studies |
Pharmacy areas Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | No studies |
Cyclophosphamide Closed‐system transfer device plus safe handling vs safe handling alone | RR 0.89 [0.78, 1.01] | NR | Very low Downgraded: risk of bias, imprecision, indirectness, publication bias |
Ifosfamide Closed‐system transfer device plus safe handling vs safe handling alone | RR 0.94 [0.74, 1.19] | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Methotrexate Closed‐system transfer device plus safe handling vs safe handling alone | RR 0.84 [0.58, 1.22] | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
5‐fluorouracil Closed‐system transfer device plus safe handling vs safe handling alone | RR 0.63 [0.42, 0.94] | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Cytarabine Closed‐system transfer device plus safe handling vs safe handling alone | RR 0.72 [0.18, 2.86] | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Gemcitabine Closed‐system transfer device plus safe handling vs safe handling alone | RR 0.96 [0.6, 1.54] | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Irinotecan, docetaxel, paclitaxel, vinorelbine, ganciclovir, epirubicin, multiple drugsϯ Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Patient‐care areas Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | No studies |
5‐fluorouracil, cytarabine, gemcitabine, irinotecan, docetaxel, paclitaxel, vinorelbine, multiple drugsϯ Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Cyclophosphamide‡ Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Epirubicin Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Cytarabine, gemcitabine, and irinotecan Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
5‐fluorouracil, cytarabine, gemcitabine, and irinotecan Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Other measures of contamination Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | No studies |
Closed‐system transfer device plus safe handling versus safe handling alone for reducing healthcare staff exposure to infusional hazardous drugs: clinical outcomes
Population: healthcare staff who handle infusional hazardous drugs
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Health outcomes Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | No studies |
Adverse events Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | No studies |
Potential cost savings Closed‐system transfer device plus safe handling vs safe handling alone | no estimate extracted | NR | Very low Downgraded: risk of bias, inconsistency |