National recommendations for the safe handling of hazardous drugs by pharmacy technicians in Portugal: A modified delphi study
BackgroundOccupational exposure to hazardous drugs is a recognised occupational risk in hospital pharmacy practice. Although international guidelines are available, the implementation is heterogeneous, and there are currently no formally endorsed national recommendations regarding the safety of pharmacy technicians in Portugal.ObjectiveTo develop consensus-based national recommendations for the safe handling of hazardous drugs by pharmacy technicians in Portugal.MethodsA modified Delphi study was conducted involving 43 invited experts from Portuguese hospital pharmacies. Fifty-eight statements were evaluated using a 0-10 agreement scale through one formal quantitative round, followed by a structured online consensus validation meeting and documentary confirmation. Consensus was predefined as a median score >7.ResultsThirty-six experts completed Round 1 (response rate 83.7%). All 58 statements voted on in Round 1 achieved consensus, with median scores of 10 for all recommendations and 98% of ratings ≥7. Following consolidation and merging procedures, the final set comprised 55 recommendations. The final recommendations were organised into five domains: occupational health surveillance, engineering controls and PPE, preparation technique and quality assurance, administrative safeguards, and environmental contamination and waste management.ConclusionsThis study establishes the first structured national consensus on hazardous drug handling safety for pharmacy technicians in Portugal. The resulting framework supports harmonisation of institutional practices, strengthens occupational risk governance, and provides a foundation for future implementation and evaluation studies.
Authors
- Nuno Miguel Silva
- Anabela Andrade
- Ana Rita Simões (ORCID: https://orcid.org/0000-0002-8231-8201)
- Elisabete Vieira (ORCID: https://orcid.org/0000-0003-3593-368X)
- Fernando Moreira (ORCID: https://orcid.org/0000-0002-3452-1459)
- Ana Costa-Veiga (ORCID: https://orcid.org/0000-0002-5183-9872)
- C Pereira
- Carla Perpétuo (ORCID: https://orcid.org/0000-0002-6903-3770)
- Carolina Valeiro (ORCID: https://orcid.org/0000-0001-9015-2259)
- Ana Rita Reis (ORCID: https://orcid.org/0000-0001-9252-7050)
- João José Joaquim (ORCID: https://orcid.org/0000-0001-9979-0062)
- Cristina Carriço
- Cristiano Matos (ORCID: https://orcid.org/0000-0002-6279-1421)
- Andréia Oliveira (ORCID: https://orcid.org/0000-0001-8759-059X)
- Luís Valadares
- Vânia Oliveira
- Milene Ramires
- André Marques (ORCID: https://orcid.org/0009-0008-6941-8620)
- Olívia R. Pereira (ORCID: https://orcid.org/0000-0002-6275-3134)
- Maria Baeta
- Rafaela Pinto
- Tânia Guedelha
- Sofia Roque Grilo (ORCID: https://orcid.org/0009-0003-3777-7104)
- Ana Costa
- Sofia Vieira
- Mariana Couras
- Susana Sequeira (ORCID: https://orcid.org/0009-0009-6773-0837)
- Joana Santos (ORCID: https://orcid.org/0009-0003-2342-5394)
- Ana Silva (ORCID: https://orcid.org/0000-0003-0880-2959)
- Ana Alves (ORCID: https://orcid.org/0000-0002-1208-9992)
- Joana Vilar
- Paula Bustorff Guerra (ORCID: https://orcid.org/0000-0002-9095-4574)
- Pedro Alexandre (ORCID: https://orcid.org/0000-0003-1021-5825)
- Ricardo Pelota (ORCID: https://orcid.org/0009-0000-9005-4448)
- Vítor Silva (ORCID: https://orcid.org/0009-0000-9402-0341)
- Tiago Freire
- Sofia Alves Gomes
Institutions
- Champalimaud Foundation (PT)
- Instituto Português de Oncologia de Coimbra Francisco Gentil (PT)
- Universidade do Porto (PT)
- Universidad de Salamanca (ES)
- Universidade Politécnica de Lisboa (PT)
- Renal Association (GB)
- Hospitais da Universidade de Coimbra (PT)
- Universidade Politécnica de Bragança (PT)
- Unidade Local de Saúde de São José (PT)
- Escola Superior de Tecnologia da Saúde de Coimbra (PT)
- Universidade Politécnica da Guarda (PT)
- Hospital de Faro EPE (PT)
- Hospital Pedro Hispano (PT)
- Administração Regional de Saúde de Lisboa e Vale do Tejo (PT)
- IPO Porto (PT)
- Escola Superior Artística do Porto (PT)
- Escola Superior de Enfermagem da Universidade de Lisboa (PT)
- Centro Hospitalar Lisboa Norte (PT)
- Instituto Politécnico de Santarém (PT)
- Hospital do Divino Espírito Santo (PT)
- Escola Superior de Enfermagem da Universidade do Porto (PT)
- Instituto de Saúde (BR)
- Rede de Química e Tecnologia (PT)
- Hospital Santo António dos Capuchos (PT)
- Escola Superior de Saúde Ribeiro Sanches (PT)
- Instituto Português de Oncologia de Coimbra Francisco Gentil (PT)
- University of Algarve (PT)
- Universidad de Sevilla (ES)
Publication Details
- Journal
- Journal of Oncology Pharmacy Practice
- Published
- 2026-04-24
- DOI
- https://doi.org/10.1177/10781552261441848
- Primary Topic
- Safe Handling of Antineoplastic Drugs
- Type
- article
- Field-Weighted Citation Impact
- 0.00