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Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review

Open access
Jung, Yoo Young, Walsh, Áine, Patel, Jig, Lai, Kit·2025·Exploratory Research in Clinical and Social Pharmacy
DOI 10.1016/j.rcsop.2025.100599PMC PMC12005321
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Abstract

When deciding whether to adopt a digital healthcare technology, there is a need to fully grasp the benefits as well as understand any potential challenges from the outset, to enable appropriate mitigations to be considered as part of implementation plans. Automated dispensing cabinets (ADCs) have been increasingly used in hospitals as a means of streamlining medicines use workflows, facilitating medicine management, saving costs, and improving patient safety. Manufacturers commonly reference the benefits of ADCs but rarely outline the challenges. It is important that senior leaders in healthcare understand both the benefits and challenges of ADCs prior to implementation, to ensure the technology is implemented in areas where the benefits can be most maximally achieved and the challenges mitigated in so far as possible. A scoping review methodology was used to map existing literature focussing on the benefits and challenges of ADC use with medicines. Following a preliminary search to identify key terms, extensive literature searches were conducted in Medline, PubMed, CINAHL, Embase, Global Health, and Web of Science. Among 234 articles identified from the search, 54 articles were included for full data extraction. Extracted information included publication date and origin, study aims & objectives, study setting, medication distribution model, technology infrastructure, overarching category, area of focus, and key findings. The findings were discussed in terms of implications for broad trends and future research directions. Although results indicate that there is an abundance of published literature on benefits and challenges associated with ADC use with medicines, there are only a handful of UK studies. Differences in settings, distribution models, workflows and technology infrastructure limit the overall ability to generalise findings. Further UK-based studies carried out in different settings with varying levels of technological infrastructure is imperative to not only track the impact of ADCs but also to inform practice to ensure the continued delivery of benefits. Further studies focusing particularly on the impact of stock optimisation and the management of CDs (Controlled drugs) would be key areas of focus.

AI snapshot

Written from the paper’s full text.

TL;DR

This scoping review maps 54 publications on the benefits and challenges of automated dispensing cabinets (ADCs) for medicines in hospital inpatient settings. It reports benefits mainly in staff efficiencies, patient safety, and cost savings, while challenges cluster around patient safety, inventory management, governance, override use, and controlled drugs, with limited UK evidence.

Key findings

  • The review included 54 papers; most were from the United States (23, 42.6%), followed by Australia (6, 11.1%) and the United Kingdom (5, 9.3%), with 13 countries represented overall.
  • Most included papers addressed clinical ward areas (48, 88.9%) rather than central pharmacy (6, 11.1%); distribution models were decentralised in 29 (53.7%) and centralised in 11 (20.4%).
  • Benefits were reported in 32 papers (59.3%), challenges in 15 (27.8%), and both in 7 (13.0%); benefit areas were mainly staff efficiencies (19, 32.8%), patient safety (18, 31.0%), and cost savings (11, 19.0%), while challenge areas were mainly patient safety (7, 30.4%), inventory management (6, 26.1%), and governance (6, 26.1%).
  • Specific reported outcomes included reduced medication administration errors (e.g., wrong dose by 79.1%, p = 0.005, and drug MAE by 93.7%, p = 0.009; dispensing error rate from 3.87 to 0 per 100,000 dispensations, p = 0.003), nursing time savings (e.g., 2.94 min to 2.37 min per dose, p = 0.006, about 66 min per ward per day), and cost findings such as estimated annual savings of $192,448 and cost avoidance of $19,660.

Methods

  • Scoping review guided by Arksey and O’Malley and reported using the PRISMA extension for scoping reviews.
  • Searches were conducted across six databases between 9 and 13 May 2024: Medline, Embase, PubMed, CINAHL, Global Health, and Web of Science; inclusion required hospital inpatient settings, ADC use for medicines as the primary intervention, and discussion of benefits and/or challenges, with no date restrictions and English-language full texts.
  • Data extraction covered citation characteristics, study design, aims, setting, medication distribution model, technology infrastructure, key findings, overarching category, and area of focus; two reviewers screened titles and abstracts, 20% of full-text papers were calibrated between reviewers, and one reviewer extracted all data from the 54 included papers.

Limitations

  • Stated: the review did not conduct a formal quality assessment of included studies, so the authors could not provide further analysis of general trends beyond their categorisations.
  • Stated: full-text data extraction was undertaken by only one reviewer, although two reviewers screened titles and abstracts and a standardised charting table was used; the review also represents only a snapshot at a particular point in time.
  • Evident from the text: differences in settings, distribution models, workflows, and technology infrastructure limit generalisability, and there are only a handful of UK studies (5, 9.3%), which the authors identify as a gap.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.rcsop.2025.100599

Cites

58 of 58 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

41 of 65 cited sources checked · 22 supported · 2 flagged · accuracy not yet measured

  • Findingcitation

    Bagattini et al. observed direct cost saving from reduced overtime payment for central pharmacy team.

    “Bagattini et al. observed direct cost saving from reduced overtime payment for central pharmacy team.13”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [13] Bagattini Â.M. Borges J.L.A. Riera R. de Carvalho D.C.M.F. Automation of a tertiary hospital pharmacy drug dispensing system in a lower-middle-income country: a case study and preliminary results Exploratory Res Clin Soc Pharm 6 2022 10.1016/j.rcsop.2022.100151 PMC9234249 35770196 source
  • Findingcitation

    Benefits in cost savings were also described as a reduction in staffing costs.

    “Benefits in cost savings were also described as a reduction in staffing costs [13,23,38,54,59,63].”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [13] Bagattini Â.M. Borges J.L.A. Riera R. de Carvalho D.C.M.F. Automation of a tertiary hospital pharmacy drug dispensing system in a lower-middle-income country: a case study and preliminary results Exploratory Res Clin Soc Pharm 6 2022 10.1016/j.rcsop.2022.100151 PMC9234249 35770196 source

      The Results table reports that annual overtime pay fell from R$26,798.82 before automation to R$4,327.35 afterward, and the Discussion describes reduced overtime pay for the central pharmacy team. This supports a reduction in one staffing expense, but not a reduction in overall staffing costs; the table shows that the number of pharmacy professionals involved rose from 48 to 59. No page number is available in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [23] De-Carvalho D. Alvim-Borges J.L. Toscano C.M. Impact assessment of an automated drug-dispensing system in a tertiary hospital Clinics 72 2017 629 10.6061/CLINICS/2017(10)07 29160426 PMC5666447 source
    • cites [38] McCarthy B.C. Ferker M. Implementation and optimization of automated dispensing cabinet technology Am J Health-Syst Pharm 73 2016 1531 1536 10.2146/AJHP150531 27646814 source
  • Findingcitation

    De-Carvalho et al. reported a reduction in nursing time spent on stock inventory counting with 6 h saved daily post-ADC implementation.

    “De-Carvalho et al. reported a reduction in nursing time spent on stock inventory counting with 6 h saved daily post-ADC implementation.23”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [23] De-Carvalho D. Alvim-Borges J.L. Toscano C.M. Impact assessment of an automated drug-dispensing system in a tertiary hospital Clinics 72 2017 629 10.6061/CLINICS/2017(10)07 29160426 PMC5666447 source

      The Results section (Healthcare professional time; page unavailable) reports that nurses spent significantly less time on drug inventory activities after implementation. It reports 6.5 work hours saved per day overall, across professional groups—not 6 hours of nursing time saved on stock inventory counting. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
  • Findingcitation

    Nurses experienced less interruptions such as colleague speaking, reduced from 5.7 pre-ADC to 3.2 post-ADC (p = 0.0008) per hour.

    “It was also reported that nurses experienced less interruptions such as colleague speaking reduced from 5.7 pre-ADC to 3.2 post-ADC (p = 0.0008) per hour.31”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [31] Jumeau M. Francois O. Bonnabry P. Impact of automated dispensing cabinets on dispensing errors, interruptions and pillbox preparation time Eur J Hosp Pharm 30 2023 237 241 10.1136/ejhpharm-2021-002849 34426488 PMC10359777 source

      The ‘Impact of ADCs on interruption’ section reports 3.2 interruptions per hour in ADC wards versus 5.7 in traditional-ward-stock wards (p=0.0008). It identifies ‘colleague speaking’ as a common type, but those rates are for all interruptions, not that type specifically. The study compared ward groups rather than measuring a pre-ADC and post-ADC change. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
  • Findingcitation

    ADC implementation is associated with reduced nursing time dedicated to selecting, preparing, and administering medication, with a mean time gain of 14.7 h per day across three intensive care units (4 h/9 beds) as reported by Chapuis et al.

    “Chapuis et al. described that nursing time dedicated to selecting, preparing, and administering medication reduced post-ADC implementation with a mean time gain of 14.7 h per day across three intensive care units (ICUs) (4 h/9 beds).19”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [19] Chapuis C. Bedouch P. Detavernier M. Automated drug dispensing systems in the intensive care unit: a financial analysis Crit Care 19 2015 10.1186/S13054-015-1041-3 PMC4563942 26349855 source

      The Results report a mean nursing time gain of 14.7 hours per day across three ICUs (4 hours per 9 beds), including less time collecting and preparing medications. The Methods list the medication-related activities assessed, but do not include administering medication; that part of the citing sentence is unsupported. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • May combine two claims. 30
  • Classified as probably not a substantial claim. 54

  • May combine two claims.

    Findingcitation

    Savings were calculated according to mean gross salary and reported as follows: full-time nurse (R$ 5869; USD 2523), administrative/hospitality assistant (R$ 1598; USD 687), materials supervisor (R$ 3526; USD 1516), and pharmacy assistant (R$ 1710; USD 735) per year during the first year after introducing the ADC.

    “Savings were calculated according to mean gross salary and reported as follows: full-time nurse (R$ 5869; USD 2523), administrative/hospitality assistant (R$ 1598; USD 687), materials supervisor (R$ 3526; USD 1516), and pharmacy assistant (R$ 1710; USD 735) per year during the first year after introducing the ADC.23”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [23] De-Carvalho D. Alvim-Borges J.L. Toscano C.M. Impact assessment of an automated drug-dispensing system in a tertiary hospital Clinics 72 2017 629 10.6061/CLINICS/2017(10)07 29160426 PMC5666447 source

      Split into 2 atoms — 1 confirmed, 0 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    Although there is literature on the benefits of continuous cycles of training with ADC implementation, no studies have recommended the frequency with which training should be undertaken.

    “Although there is literature on the benefits of continuous cycles of training with ADC implementation,33 no studies have recommended the frequency with which training should be undertaken.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [33] Lichtner V. Prgomet M. Gates P. Franklin B.D. Westbrook J.I. Challenges of digital commons: a qualitative study of an automated dispensing cabinet in a paediatric intensive care unit Stud Health Technol Inform 284 2021 244 248 10.3233/SHTI210716 34920519 source

      The citation is attached to the claimed benefits of continuous training, not to the subsequent statement about training frequency. In §3.4, the paper says training and repeated calls for compliance did not seem to address the ADC problems; the Discussion and Conclusion says training is likely to have only limited effect unless work processes change. (LLM, conf=0.85)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The use of ADCs for medicines, with associated benefits and/or limitations, was explored using a scoping review guided by the methodology of Arksey and O'Malley.

    “The use of ADCs for medicines, with associated benefits and/or limitations, was explored using a scoping review guided by the methodology of Arksey and O'Malley.5”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [5] Arksey H. O’Malley L. Scoping studies: towards a methodological framework Int J Soc Res Methodol 8 2005 19 32 10.1080/1364557032000119616 source

  • May combine two claims.

    Findingcitation

    ADC implementation resulted in a 79.1% (p = 0.005) reduction of wrong dose and drug MAEs specifically by 93.7% (p = 0.009).

    “It was described that ADC implementation resulted in a 79.1 % (p = 0.005) reduction of wrong dose and drug MAEs specifically by 93.7 % (p = 0.009),21”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [21] Cousein E. Mareville J. Lerooy A. Effect of automated drug distribution systems on medication error rates in a short-stay geriatric unit J Eval Clin Pract 20 2014 678 10.1111/JEP.12202 24917185 PMC4524418 source

  • May combine two claims.

    Findingcitation

    Tsao et al. observed that mean charge capture rates of medicines improved from 63% pre-ADC to 97% post-ADC, leading healthcare providers to bill for a larger proportion of medications used, thus improving revenue accrual rates.

    “Tsao et al. observed that mean charge capture rates of medicines improved from 63 % pre-ADC to 97 % post-ADC, leading healthcare providers to bill for a larger proportion of medications used, thus improving revenue accrual rates.54”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [54] Tsao N.W. Lo C. Babich M. Shah K. Bansback N.J. Decentralized Automated Dispensing Devices: Systematic Review of Clinical and Economic Impacts in Hospitals n.d. 2025 PMC4006759 24799724 source

  • May combine two claims.

    Findingcitation

    ADC implementation is associated with reduced nursing time for medicines administration, with Cottney et al. describing 66 min of time saving per ward per day (2.94 min pre-ADC to 2.37 min post-ADC).

    “Cottney et al. described 66 min of time saving associated with medicines administration per ward per day by nurses (2.94 min pre-ADC to 2.37 min post-ADC).20”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [20] Cottney A. Improving the safety and efficiency of nurse medication rounds through the introduction of an automated dispensing cabinet BMJ Qual Improv Rep 3 2014 10.1136/BMJQUALITY.U204237.W1843 u204237.w1843 PMC4645698 26734256 source

  • May combine two claims.

    Findingcitation

    This was explained as a redistribution of time, where time spent by nurses and administrative assistants on medication related activities decreased; however, it was noted that the time spent on stock refill and inventory activities performed by pharmacy assistants increased.

    “This was explained as a redistribution of time, where time spent by nurses and administrative assistants on medication related activities decreased; however, it was noted that the time spent on stock refill and inventory activities performed by pharmacy assistants increased.23”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [23] De-Carvalho D. Alvim-Borges J.L. Toscano C.M. Impact assessment of an automated drug-dispensing system in a tertiary hospital Clinics 72 2017 629 10.6061/CLINICS/2017(10)07 29160426 PMC5666447 source

  • May combine two claims.

    Interpretationcitation

    While there were reduced errors, changes in procedures and systems may incur a new set of risks.

    “It was highlighted that while there were reduced errors, changes in procedures and systems may incur a new set of risks.8,15”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [8] Ahtiainen H.K. Kallio M.M. Airaksinen M. Holmström A.R. Safety, time and cost evaluation of automated and semi-automated drug distribution systems in hospitals: a systematic review Eur J Hosp Pharm 27 2020 253 262 10.1136/EJHPHARM-2018-001791 32839256 PMC7447254 source
    • cites [15] Batson S. Herranz A. Rohrbach N. Canobbio M. Mitchell S.A. Bonnabry P. Automation of in-hospital pharmacy dispensing: a systematic review Eur J Hosp Pharm 28 2021 58 64 10.1136/ejhpharm-2019-002081 32434785 PMC7907692 source

      The Pharmacy-based automated dispensing systems section reports reduced dispensing errors after automation. The Ward-based automated dispensing systems section also reports interventions after implementation related to incorrect ADS procedures and handling, which suggests procedural risks. It does not establish that changes in procedures and systems created a new set of risks. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    Benefits in cost saving were observed from reduced ward stock supply and annual spend on expired medicines, decreased stockouts, and decreased stock orders from central pharmacy.

    “Benefits in cost saving were observed from reduced ward stock supply and annual spend on expired medicines, decreased stockouts, and decreased stock orders from central pharmacy [8,9,19,37,38,56,63].”
    Quote in the paperSubstantial claim3 of 3 sources checked
    • cites [8] Ahtiainen H.K. Kallio M.M. Airaksinen M. Holmström A.R. Safety, time and cost evaluation of automated and semi-automated drug distribution systems in hospitals: a systematic review Eur J Hosp Pharm 27 2020 253 262 10.1136/EJHPHARM-2018-001791 32839256 PMC7447254 source

      The review reports smaller ward storage, reduced expired-drug waste (Other outcomes; Other Medication storage), and some savings from lower drug-storage costs (effects of drug distribution systems on costs of care). Our copy does not report reduced annual spending on expired medicines, fewer stockouts, or fewer stock orders from the central pharmacy. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [9] Almalki A. Jambi A. Elbehiry B. Albuti H. Improving inpatient medication dispensing with an automated system Glob J Qual Saf Healthcare 6 2023 117 125 10.36401/JQSH-23-15 PMC10887473 38404460 source

      The Results report an 81% reduction in ward stock and an estimated annual saving of $750,000 from expired medications. The Discussion mentions stock-outs only as an established metric the project did not select; it does not report decreased stock-outs or fewer stock orders from central pharmacy. No page numbers are available in our copy. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites [19] Chapuis C. Bedouch P. Detavernier M. Automated drug dispensing systems in the intensive care unit: a financial analysis Crit Care 19 2015 10.1186/S13054-015-1041-3 PMC4563942 26349855 source

      The Abstract Results report lower drug-storage costs and annual costs for expired drugs; the Results report fewer missing medications (84 to 37). The Results also show less nursing time spent ordering and stocking medications, but do not establish that the number of stock orders from central pharmacy decreased or that fewer missing medications produced measured cost savings. The supplied copy gives no page numbers for these passages. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    As a result of ADC implementation, pharmacy staff reported more time available for clinical activities, leading to an improvement in the overall quality of care delivered to patients.

    “As a result of ADC implementation pharmacy staff reported more time available for clinical activities, leading to an improvement in the overall quality of care delivered to patients.8,23,27,28,32,52,54”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [8] Ahtiainen H.K. Kallio M.M. Airaksinen M. Holmström A.R. Safety, time and cost evaluation of automated and semi-automated drug distribution systems in hospitals: a systematic review Eur J Hosp Pharm 27 2020 253 262 10.1136/EJHPHARM-2018-001791 32839256 PMC7447254 source
    • cites [23] De-Carvalho D. Alvim-Borges J.L. Toscano C.M. Impact assessment of an automated drug-dispensing system in a tertiary hospital Clinics 72 2017 629 10.6061/CLINICS/2017(10)07 29160426 PMC5666447 source

      The Discussion (page unavailable) says automated dispensing provides pharmacists more time for clinical work, and the Introduction describes a potential benefit to patient care. But this study measured work time rather than pharmacy staff reports, and it does not establish that the overall quality of care delivered to patients improved. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [27] Fox E. Misko J. Cheaib A. An evaluation of automated dispensing cabinets and inventory robots for centralised distribution of medication in an Australian hospital Aust Health Rev 45 2021 597 600 10.1071/AH20331 34181871 source

  • May combine two claims.

    Findingcitation

    The time taken for nurses to undertake CD counts was perceived to have reduced significantly, however, this was not quantified.

    “The time taken for nurses to undertake CD counts was perceived to have reduced significantly, however, this was not quantified.34”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [34] Lichtner V. Prgomet M. Gates P. Franklin B.D. Automatic dispensing cabinets and governance of controlled drugs: an exploratory study in an intensive care unit Eur J Hosp Pharm 30 2023 17 23 10.1136/EJHPHARM-2020-002552 33975929 PMC9811539 source

  • May combine two claims.

    Findingcitation

    Tasks shown to take more time post-ADC implementation include item refilling and reorganising stock inventory (undertaken by pharmacy staff) and retrieval of items causing nursing queues at the cabinet.

    “The types of tasks which have been shown to take more time post ADC implementation included item spent refilling and reorganising stock inventory; both of which are undertaken by pharmacy staff,23 and retrieval of items causing nursing queues at the cabinet.22”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [23] De-Carvalho D. Alvim-Borges J.L. Toscano C.M. Impact assessment of an automated drug-dispensing system in a tertiary hospital Clinics 72 2017 629 10.6061/CLINICS/2017(10)07 29160426 PMC5666447 source
    • cites [22] Craswell A. Bennett K. Hanson J. Dalgliesh B. Wallis M. Implementation of distributed automated medication dispensing units in a new hospital: nursing and pharmacy experience J Clin Nurs 30 2021 2863 2872 10.1111/JOCN.15793 33931903 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Balka et al. identified that reluctance to report discrepancies and staff shortages during ADC implementation could lead to ineffective use of ADCs, which potentially impacts patient safety due to unresolved or unreported discrepancies and improper use of the system.

    “Similarly, Balka et al. identified that reluctance to report discrepancies and staff shortages during ADC implementation could lead to ineffective use of ADCs, which potentially impacts patient safety due to unresolved or unreported discrepancies and improper use of the system.15”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [15] Batson S. Herranz A. Rohrbach N. Canobbio M. Mitchell S.A. Bonnabry P. Automation of in-hospital pharmacy dispensing: a systematic review Eur J Hosp Pharm 28 2021 58 64 10.1136/ejhpharm-2019-002081 32434785 PMC7907692 source

      Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Interpretationcitation

    The safety concerns identified can be addressed through effective models of training, continuous cycles of optimisation, and improved monitoring through report utilisation.

    “All these concerns can be addressed through effective models of training, continuous cycles of optimisation and improved monitoring through report utilisation.10,34,43”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites [10] Alzahrani A.A. Aledresee T.M. Alzahrani A.M. Issues faced by pharmacy technicians while maintaining automated dispensing cabinets and how to overcome them in the National Guard Health Affairs in Riyadh: a qualitative study Cureus 15 2023 10.7759/CUREUS.42210 PMC10439815 37602092 source

      The Discussion (page not provided) proposes training ADC users and using safety reports to investigate medication discrepancies. It does not describe continuous cycles of optimisation, and the Conclusions frame the identified errors primarily as workflow problems rather than patient harms. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [34] Lichtner V. Prgomet M. Gates P. Franklin B.D. Automatic dispensing cabinets and governance of controlled drugs: an exploratory study in an intensive care unit Eur J Hosp Pharm 30 2023 17 23 10.1136/EJHPHARM-2020-002552 33975929 PMC9811539 source

      The Results (Monitoring; page unavailable) describe pharmacists using ADC reports to monitor controlled-drug discrepancies, and the Methods (Observations; page unavailable) document nurse training. The Discussion (page unavailable) describes monitoring and resolving discrepancies as ongoing. The paper does not establish that effective training models and continuous optimisation cycles can address all the safety concerns identified, so the sentence overstates its findings. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
    • cites [43] Repella E. Hagen Z. Carson S. Wang F. Regionalized health system review of automated dispensing cabinet overrides J Med Syst 46 2022 1 7 10.1007/S10916-021-01792-X/FIGURES/2 34791529 source

  • Classified as probably not a substantial claim.

    Interpretationcitation

    Despite increased costs, potential cost savings of avoided MAEs of 258 avoided administration errors, 178 procedural errors, and 27 clinical errors per 100 patient-days could balance the incremental costs.

    “However, Risør et al. added that despite increased costs, potential cost savings of avoided MAEs of 258 avoided administration errors, 178 procedural errors, and 27 clinical errors per 100 patient-days could balance the incremental costs.47”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [47] Risør B.W. Lisby M. Sørensen J. Cost-effectiveness analysis of an automated medication system implemented in a Danish hospital setting Value Health 20 2017 886 893 10.1016/j.jval.2017.03.001 28712617 source

  • May combine two claims.

    Findingcitation

    Bagattini et al. described the benefits of streamlining medication selection with ADCs in reducing MAEs however also highlighted that prescribing and distribution errors persisted.

    “Bagattini et al. described the benefits of streamlining medication selection with ADCs in reducing MAEs however also highlighted that prescribing and distribution errors persisted.13”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [13] Bagattini Â.M. Borges J.L.A. Riera R. de Carvalho D.C.M.F. Automation of a tertiary hospital pharmacy drug dispensing system in a lower-middle-income country: a case study and preliminary results Exploratory Res Clin Soc Pharm 6 2022 10.1016/j.rcsop.2022.100151 PMC9234249 35770196 source

      The Results report a lower dispensing-error rate after automation and show that prescription and distribution errors still occurred in 2017. However, the Methods identify the intervention studied as central-pharmacy PillPick and BoxPicker robots, not automated dispensing cabinets (ADCs); the paper does not attribute its findings to streamlined medication selection with ADCs. (LLM, conf=0.85)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    Calculations of ADC implementation cost per 100 patient days (€1117 per 100 patient-days) reported to be higher than that of conventional medication management (€615 per 100 patient-days), corresponding to incremental costs of €502 per 100 patient-days.

    “Calculations of ADC implementation cost per 100 patient days (€1117 per 100 patient-days) reported to be higher than that of conventional medication management (€615 per 100 patient-days), corresponding to incremental costs of €502 per 100 patient-days.47”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [47] Risør B.W. Lisby M. Sørensen J. Cost-effectiveness analysis of an automated medication system implemented in a Danish hospital setting Value Health 20 2017 886 893 10.1016/j.jval.2017.03.001 28712617 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    With duplicate publications removed, 192 publications were progressed to the next stages of review.

    “With duplicate publications removed, 192 publications were progressed to the next stages of review.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    234 articles were identified from the search.

    “Among 234 articles identified from the search”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The literature search yielded a total of 248 publications across six databases.

    “The literature search yielded a total of 248 publications across six databases.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The review identified 54 papers for inclusion.

    “54 articles were included for full data extraction.”
    • Also stated in: § Article characteristics · plain
      “The review identified 54 papers.”
    • Also stated in: § Study selection · plain
      “One reviewer extracted all data from the full texts of 54 included publications.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Eight of the included publications were categorised as perception papers (14.8%).

    “eight perception papers (14.8 %),”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The number of papers published on medicines ADC use across hospital inpatient settings has increased significantly in recent years.

    “The number of papers published on medicines ADC use across hospital inpatient settings has increased significantly in recent years as illustrated in Fig. 2.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    At the title and abstract screening stages, 82 and 46 publications were excluded respectively.

    “At the title and abstract screening stages, 82 and 46 publications were excluded respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Williams et al. observed a reduction in nursing and pharmacy workload of 2.38 h per patient per day and estimated savings in the range of $192,448 annually, including a significant reduction in costs attributed to lost inventory ($542.98 monthly pre-ADC to $1.82 3-months post-ADC).

    “Williams et al. observed a reduction in nursing and pharmacy workload of 2.38 h per patient per day and estimated savings in the range of $192,448 annually, including a significant reduction in costs attributed to lost inventory ($542.98 monthly pre-ADC to $1.82 3-months post-ADC).59”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Williams C.T. Lee V.F. Marsalis L.D. Implementation of an automated medicationsupply distribution system Hosp Mater Manage Q 16 2 1994 76 79 https://pubmed.ncbi.nlm.nih.gov/10137784/ (accessed February 11, 2025) 10137784

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    For a proportion of papers, the infrastructure was not described (n = 3, 5.6%) or not applicable (n = 4, 7.4%).

    “For a proportion of papers, the infrastructure was not described (n = 3, 5.6 %) or not applicable (n = 4, 7.4 %),”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Twenty-six of the included publications were categorised as evaluation papers (48.1%).

    “Twenty-six of the included publications were categorised as evaluation papers (48.1 %),”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    An additional two publications were added from external sources.

    “An additional two publications were added from external sources.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    A total of 64 publications were screened as full text with a further 10 publications excluded.

    “A total of 64 publications were screened as full text with a further 10 publications excluded.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Many publications had more than one area of focus.

    “Of note, many publications had more than one area of focus.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    ADC with electronic health record (EHR) accounted for 3.7% (n = 2) of the technology infrastructure described.

    “ADC with electronic health record (EHR) 3.7 % (n = 2),”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Five of the included publications were categorised as intervention papers (9.3%).

    “five intervention papers (9.3 %).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Overall 13 countries published research associated with benefits and challenges of ADC use within hospital inpatient settings.

    “overall 13 countries published research associated with benefits and challenges of ADC use within hospital inpatient settings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among benefits papers, the main areas of focus were staff efficiencies (n = 19, 32.8%), patient safety (n = 18, 31.0%), and cost savings (n = 11, 19.0%).

    “When considering the benefits papers, the main areas of focus were staff efficiencies (n = 19, 32.8 %), patient safety (n = 18, 31.0 %), and cost savings (n = 11, 19.0 %).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In the reviewed literature, the distribution model was defined as either centralised (n = 11, 20.4%) or decentralised (n = 29, 53.7%).

    “In the reviewed literature, this was defined as either centralised (n = 11, 20.4 %) or decentralised (n = 29, 53.7 %) models of distribution.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The most common reason for exclusion was due to inability to access the full-text article.

    “The most common reason for exclusion was due to inability to access the full-text article.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Most papers were published in the United States (42.6%).

    “Most papers were published in the United States (42.6 %) with a relatively low number of publications originating from the UK (9.3 %); overall 13 countries published research associated with benefits and challenges of ADC use within hospital inpatient settings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The importance of a continuous cycle of improvement for both hardware and software functionality was noted in the literature but not explored in detail.

    “Furthermore, the importance of a continuous cycle of improvement for both hardware and software functionality was noted to be of importance but not explored in detail.22”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Craswell A. Bennett K. Hanson J. Dalgliesh B. Wallis M. Implementation of distributed automated medication dispensing units in a new hospital: nursing and pharmacy experience J Clin Nurs 30 2021 2863 2872 10.1111/JOCN.15793 33931903 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    There are relatively small numbers of publications that looked at long-term use of ADCs.

    “The relatively small numbers of publications that looked at long-term use of ADCs is also worth highlighting at this point.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The unnecessarily frequent use of the override function was described as a challenge and explored in many studies; safety concerns associated with unnecessary override use was a key concern.

    “The unnecessarily frequent use of override function was described as a challenge and explored in many studies.11,42,43,45”
    • Also stated in: § Discussion · plain
      “Safety concerns associated with the unnecessary use of override functions was a key concern.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [11] Aschenbrenner D.S. Automated dispensing cabinet overrides should be considered risky, not routine AJN 123 2023 17 10.1097/01.NAJ.0000944908.02445.0f 37345776 source
    • cites [42] Paterson E.P. Manning K.B. Schmidt M.D. Provine A.D. Automated dispensing cabinet overrides—an evaluation of necessity in a pediatric emergency department J Emerg Nurs 48 2022 319 327 10.1016/j.jen.2022.01.007 35526877 source
    • cites [43] Repella E. Hagen Z. Carson S. Wang F. Regionalized health system review of automated dispensing cabinet overrides J Med Syst 46 2022 1 7 10.1007/S10916-021-01792-X/FIGURES/2 34791529 source

  • May combine two claims.

    Findingown data

    Publications described both benefits of ADC use with controlled drugs (e.g., automated recording of CD transactions by user and associated nursing time savings) and governance challenges.

    “Publications not only described the benefits of ADC use with CDs e.g. automated recording of CD transactions by user and associated nursing time savings but also focussed on the governance challenges experienced.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingnone given

    The details of training delivery methods and training content have not been sufficiently explored.

    “Furthermore, the details of training delivery methods and training content have not been sufficiently explored.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    This scoping review examined, categorised, and described ADC literature, providing an overview of published benefits and challenges.

    “This scoping review was able to examine, categorise and describe ADC literature providing an overview of published benefits and challenges”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    The review identified key gaps in literature on benefits and challenges of ADC use with medicines, including the need for further research in the UK.

    “Through this review, we were able to identify key gaps in literature specifically focusing on benefits and challenges of ADC use with medicines, including the need for further research in the UK.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The use of ADCs is becoming more commonplace in the UK.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Many studies emphasised that ADCs improve staff efficiency by automating manual procedures.

    “While it was emphasised in many studies that ADCs improve staff efficiency by automating manual procedures”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    This scoping review categorised ADC publications according to study types: intervention, evaluation, perception, and optimisation, and specified the key areas of focus of each publication.

    “This scoping review has categorised ADC publications according to study types: intervention, evaluation, perception, and optimisation and further specified the key areas of focus of each publication.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    There has been an increase in the number of other technologies that ADCs exist with since their establishment over 30 years ago.

    “This scoping paper demonstrates that there has been an increase in the number of other technologies that ADCs exist with since their establishment over 30 years ago.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    An extensive literature search was conducted across six databases (Medline, Embase, PubMed, CINAHL, Global Health, and Web of Science) between 9 and 13 May 2024.

    “An extensive literature search was then conducted across six databases between the 9th and 13th May 2024: Medline, Embase, PubMed, CINAHL, Global Health, and Web of Science.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    An independent review of the overarching categorisation was undertaken by both reviewers.

    “An independent review of the overarching categorisation was also undertaken by both reviewers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    One reviewer extracted all data from the included papers using a piloted charting table developed to support the extraction and collation of key information from eligible publications.

    “One reviewer extracted all data from the included papers using a piloted charting table developed to support the extraction and collation of key information from eligible publications.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The importance of a clear vision from the outset of any change management project is widely recognised as one of the factors influencing a successful outcome.

    “The importance of a clear vision from the outset of any change management project is widely recognised as one of the factors influencing a successful outcome.4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Kotter J. John Kotter's Eight Step Change Model n.d. https://www.managementstudyguide.com/kotters-8-step-model-of-change.htm

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    A calibration exercise was undertaken where 20% of full-text papers were randomly selected using Excel RAND function for discussion by the two reviewers to determine the content for inclusion in Table 4.

    “A calibration exercise was then undertaken where 20 % of full-text papers were randomly selected using the Excel RAND function for discussion by the two reviewers to determine the content for inclusion in Table 4.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    These enhancements enable the shift of focus from manual inventory management tasks to clinical patient facing tasks, which was the overarching aim of the Carter Report.

    “In turn, these enhancements enable the shift of focus from manual inventory management tasks to clinical patient facing tasks which was the overarching aim of the Carter Report.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Productivity in NHS hospitals - GOV.UK (n.d.) https://www.gov.uk/government/publications/productivity-in-nhs-hospitals (accessed September 17, 2024)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Language, year and country of publication filters were not applied.

    “Language, year and country of publication filters were not applied.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Any differences were discussed with further refinement to the data set collated to reach a consensus.

    “Any differences were discussed with further refinement to the data set collated to reach a consensus.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    This paper adheres to the PRISMA extension for scoping reviews.

    “This paper adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] PRISMA (n.d.) http://www.prisma-statement.org/ (accessed March 27, 2024)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study selection process involved the screening of titles and abstracts by two independent reviewers to determine eligibility for full text screening based on the two pre-determined search concepts.

    “The study selection process involved the screening of titles and abstracts by two independent reviewers to determine eligibility for full text screening based on the two pre-determined search concepts.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The benefits of ADCs have broadly been described to include streamlining of medication management, optimisation of workflow efficiencies, cost efficiencies, and improving the quality of care provided to patients.

    “The benefits of ADCs have broadly been described to include the streamlining of medication management, optimisation of workflow efficiencies, cost efficiencies, and improving the quality of care provided to patients.1,2”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] 4 Benefits of Automated Dispensing Cabinets (ADCs) for Long-Term Care Facilities | Capsa Healthcare, (n.d.). https://www.capsahealthcare.com/4-benefits-of-automated-dispensing-cabinets-adcs-for-long-term-care-facilities/ (accessed July 17, 2024).

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [2] Points of Care | Omnicell (n.d.) https://www.omnicell.com/points-of-care (accessed July 17, 2024)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    The breadth of literature reviewed and the way it has been consolidated allows hospitals considering ADC implementation to foresee and better plan for challenges and to understand, more fully, the benefits ADCs bring.

    “The breadth of literature reviewed and the way it has been consolidated allows hospitals considering ADC implementation to foresee and better plan for challenges and to understand, more fully, the benefits ADCs bring.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The results of this scoping review only represent a snapshot at a particular point in time.

    “the results of this scoping review only represent a snapshot at a particular point in time.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The scoping review was conducted according to Arksey and O'Malley's scoping review methodology.

    “We utilised scoping review methodology according to Arksey and O'Malley5 to examine and report on the extent and range of benefits and challenges associated with ADC use for medicines.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Arksey and O'Malley5

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Better interoperability of ADCs with other technologies may require further software developments by providers.

    “Better interoperability of ADCs with other technologies may require further software developments to be undertaken by the providers.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The review did not conduct a formal quality assessment of included studies.

    “we did not conduct a formal quality assessment of included studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Regular review and reporting of override transactions supports assurance on compliance with workflows and helps identify potential issues with the system, enabling pharmacy staff to operate more prospectively.

    “The ability to regularly review and report on override transactions also supports providing assurance on compliance with workflows whilst helping to identify any potential issues with the system so that pharmacy staff can operate in more of a prospective rather than retrospective manner.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    20% of papers were randomly selected for discussion between the two reviewers to determine content for inclusion to support validation.

    “20 % of papers were randomly selected for discussion between the two reviewers to determine the content for inclusion to support validation of the piece.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    As more NHS hospitals implement ADC technology, the definition of outcomes achieved is useful to further substantiate findings from studies in other countries.

    “As more NHS hospitals implement ADC technology the definition of outcomes achieved is useful to further substantiate findings from studies in other countries.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The review was unable to provide further analysis of general trends beyond the categorisations applied.

    “We were therefore unable to provide further analysis of general trends beyond the categorisations applied.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The review is a useful summary for hospitals planning to introduce these systems.

    “making it a useful summary for hospitals planning to introduce these systems.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The variation in ADC distribution models between countries is possibly reflective of the respective healthcare systems including how they are funded.

    “This is possibly reflective of the respective healthcare systems including how they are funded.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The UK healthcare system is funded through taxation and free at the point of use.
    • Rests on an assumption: The US healthcare system relies on private insurance and charges per dose.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Two independent reviewers screened titles and abstracts to determine eligibility for inclusion, and a standardised data charting table was used to summarise key findings to ensure consistency.

    “two independent reviewers screened title and abstracts to determine eligibility for inclusion in the review and a standardised data charting table was used to summarise key findings to ensure consistency of information collated.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Full-text extraction of data was only undertaken by one reviewer.

    “full-text extraction of data was only undertaken by one reviewer owing to the number of studies identified.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The review comprehensively assessed trends in dates, geographic locations, and healthcare settings of research, and reviewed study types, summarising associated outcomes published.

    “We comprehensively assessed trends in dates, geographic locations and healthcare settings of research and also reviewed study types; summarising associated outcomes published.”
    Quote in the paperSubstantial claim
72 of 72

  • The paper relies on this without support.

    No overarching synthesis of literature on ADCs exists that can be referenced.

    “Specifically, at the time of writing, the authors were not aware of any overarching synthesis of literature on ADCs that can be referenced.”

  • The paper relies on this without support.

    A mapping of the landscape of research regarding benefits and challenges of ADC use with medicines has not yet been fully conducted.

    “to date, a mapping of the landscape of research regarding benefits and challenges of ADC use with medicines is yet to be fully conducted.”

  • The paper relies on this without support.

    Assessing the benefits of ADCs in isolation is challenging when more than one system co-exists.

    “In addition, assessing the benefits of ADCs in isolation can be challenging when more than one system co-exists.”

  • The paper relies on this without support.

    The use of ADCs is becoming more commonplace in the UK.

    “More research with clear detail regarding study setting and study design would help to inform practice in the UK where the use of ADCs is becoming more commonplace.”

  • The paper relies on this without support.

    The introduction of any new technology can introduce new risks.

    “The introduction of any new technology can introduce new risks.”

  • The paper relies on this without support.

    In practice, override functions are necessary to prevent delays in medicine retrieval.

    “In practice, override functions are necessary to prevent delays in medicine retrieval.”

  • The paper relies on this without support.

    Override functions are an integral functionality of ADCs.

    “Being an integral functionality of ADCs, local procedures should clearly define the instances where use of overrides are accepted.”

  • The paper relies on this without support.

    The UK healthcare system is funded through taxation and free at the point of use.

    “This is in comparison to the decentralised medicines distribution model observed in UK hospitals, where healthcare provided by the National Health Service (NHS) is generally free at the point of use; a healthcare system funded through taxation.”

  • The paper relies on this without support.

    The US healthcare system relies on private insurance and charges per dose.

    “As an example, there may be a need to operate a centralised medicines distribution model in the United States where each medicine dose unit supplied to patients is charged and private insurance is commonly relied upon to fund healthcare.”
9 of 9

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Abstract and results give different search totals

    Minor

    The abstract says the search identified 234 articles, while the results say it yielded 248 publications.

  • De-Carvalho citation number differs from its table entry

    Minor

    The discussion cites De-Carvalho et al. as reference 29, whereas Table 4 identifies that publication as reference 23.

  • Balka citation number differs from its table entry

    Minor

    The discussion cites Balka et al. as reference 15, whereas Table 4 identifies the Balka publication as reference 14.

  • Two additional publications are missing from the final count

    Minor

    Screening 64 full texts and excluding 10 leaves 54. If two publications were then added from external sources, the final count would be 56 rather than 54.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Lupi, 2019, 33, 576
  2. Williams, 1994, Implementation of an automated medicationsupply distribution system, Hosp Mater Manage Q, 16, 76

Cited by

Sorted by citations

Related

Authors
Jung, Y. Y., Walsh, Á., Patel, J., & Lai, K.
Affiliations
  • King's College London (GB)
  • King's College Hospital NHS Foundation Trust (GB)
Corresponding author
Jung, Yoo Young
Venue
Exploratory Research in Clinical and Social Pharmacy
Publisher
Elsevier BV
Published
2025-06
Volume
18
Pages
100599
ISSN
2667-2766 (ISSN-L)
DOI
10.1016/j.rcsop.2025.100599
PMC
PMC12005321
OpenAlex
W4409150949
Semantic Scholar
a980a33bcef0c230127cf97126000392fd3cc878
Cited by
7
References
55
Citations by year
2026: 2 · 2025: 5
FWCI
5.20
Type
journal article
Language
en
Open access
Licence
Locations
  • Exploratory Research in Clinical and Social Pharmacy (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by)
  • PubMed Central (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
Keywords
automated dispensing cabinets, hospital pharmacy, medication distribution, medication management, patient safety, implementation barriers, technology adoption, controlled substances

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-20.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-20.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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