Development of a unified approach to hazardous medicinal product management using closed system drug transfer devices

ObjectiveTo provide an overview of global directives, standards, guidelines, and best practices in the management of hazardous medicinal products (HMPs) with closed system drug transfer devices (CSTDs).Data sourcesA literature review was performed using PubMed on CSTD performance, use, and cost-effectiveness. The authors provided information on directives, standards, and guidelines. A roadmap was proposed, which is the expert opinion of the authors.Data summaryDespite evidence supporting CSTD use and their successful implementation in the United States, their usage remains inconsistent in Europe. Additionally, directives, standards, and guidelines on the safe management of HMPs vary in their recommendations. A unified approach to hazardous medicinal product management using CSTDs is therefore needed which includes training, action by professional societies, clear stances from professional bodies on which CSTDs are recommended, development and wider use of testing protocols, identification of current variables in directives and guidelines, and general alignment on these.ConclusionsThere is a need for global alignment on HMP management and when to use CSTDs. Implementation of the proposed roadmap will lead to improvements in the safety of healthcare practitioners exposed to HMPs.