(1338) Enhancing Pharmacy Efficiency and Safety: A Comparative Analysis of On-body Delivery vs. Manual Syringe Pulls for Drug Preparation

Objectives: 1) Assess pharmacists' perceptions regarding on-body delivery systems (OBDS) versus manual syringes in terms of ease, efficiency, and safety for the preparation of large volume subcutaneous biologic drugs
2) Examine how OBDS affects drug preparation, focusing on time efficiency, preparation site (nurse chairside outside of the sterile compounding pharmacy) and physical strain during preparation of large volume SC biologic drugs
3) Identify factors influencing pharmacists' choice between manual syringes and Product X, and explore adoption barriers.

Methods: The study utilized a double-blinded online survey, managed by an independent third-party vendor. Participants were academic or private practice US pharmacists experienced in preparing large volume subcutaneous biologics like Darzalex Faspro (daratumumab/hyaluronidase), Rituxan Hycela (rituximab/hyaluronidase) and several others that are coformulated with hyaluronidase which is a viscous substance that creates challenges with sterile compounding. The survey began with 15 screening questions to gather demographic and professional experience information. The main 18-item questionnaire explored topics such as ease of use, preference for OBDS versus manual preparation, reasons for preference, and opinions on the OBDS's potential impact on efficiency and safety in pharmacy practices. This method aimed to provide comprehensive insights into pharmacists' preferences and perceptions of innovative drug preparation technologies. These survey results serve to guide injection system developers around pharmacist preferences and may also be beneficial for pharmacy administrators to understand challenges in workflow.

Results: Of the 30 pharmacists, 53.3% (16/30) of participants were from an academic hospital and 43.4% (13/30) were directors of pharmacy while the remainder of pharmacists were those doing the daily preparation tasks. Among the participants, there was a mean practice time of 17.77 years and a robust familiarity around the preparation of large volume SC drugs coformulated with hyaluronidase. 56.67% (17/30) were very involved in reviewing and evaluating policies around drug reconstitution workflow in the pharmacy.

In the study, all participants (30/30) reported OBDS as easier to learn and prepare compared to traditional syringes. In a theoretical scenario comparing Darzalex Faspro preparation of syringe versus OBDS, 86.67% (26/30) preferred OBDS. Factors influencing this preference included preparation time, effort, and the flexibility offered by Product X. In the same scenario when the exploratory benefit of reduced vial warming time was added, preference for OBDS preparation of Darzalex Faspro increased to 100% (30/30). In this scenario, reduced vial warming time, optionality in preparation site, time, effort and storage. Key attributes influencing decision-making were drug preparation time, effort, optionality in the preparation site and drug storage time. The potential of an OBDS to offer more flexible and efficient preparation options was highlighted, with 96.67% (29/30) believing it would reduce physical burden and 90% (27/30) anticipating a reduction in preparation errors. Additionally, all pharmacists (30/30) agreed that OBDS could eliminate the risk of needlestick injuries. 73.3% (22/30) pharmacists stated that the OBDS provides more optionality when adjusting hospital protocols.

Conclusions: In this survey, pharmacists exhibited a strong preference for OBDS over a needle and syringe, which increased from 86.67% to 100% when the exploratory benefit of reduced vial warming time was added. This scenario demonstrates the value of reducing warming time and the burden that it represents in the pharmacy workflow. The results of this survey underscore the OBDS's ability to improve efficiency, reduce physical burden, and provide flexibility in preparation and storage. Significantly, the optionality in preparation site offered by OBDS, allowing removal from sterile compounding workflows, was a major benefit. Additionally, all pharmacists agreed on OBDS's safety in eliminating needlestick injuries, with many recognizing its advantage in adjusting hospital protocols.