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Automation of in-hospital pharmacy dispensing: a systematic review

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Batson, Sarah, Herranz, Ana, Rohrbach, Nicolas, Canobbio, Michela, Mitchell, Stephen A, Bonnabry, Pascal·2021·European Journal of Hospital Pharmacy
DOI 10.1136/ejhpharm-2019-002081PMC PMC7907692
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Abstract

OBJECTIVES: The current systematic review (SR) was undertaken to identify and summarise the published literature reporting on the clinical and economic value of automated in-hospital pharmacy services with a primary focus on systems supporting the dispensing of medicines. METHODS: Literature searches were conducted in MEDLINE, Embase and the Cochrane Library on 17 December 2017 to identify English-language publications investigating any automated dispensing systems (ADSs) in the inpatient setting to include central pharmacy and ward-based systems. RESULTS: 4320 publications were screened by title and abstract and 45 of 175 full publications screened were included. Grey literature searching identified an additional three publications. Therefore, 48 publications relating to ADSs were eligible for inclusion. Although a relatively large evidence base was identified as part of the current SR, the eligible studies were inconsistent in terms of their design and the format of reporting of outcomes. The studies demonstrate that both pharmacy and ward-based ADSs offer benefits over traditional manual dispensing methods in terms of clinical and economic outcomes. The primary benefits following implementation of an ADS include reductions in medication errors, medication administration time and costs. Studies examining optimisation/inventory management strategies/refill programmes for these systems suggest that optimal implementation of the ADS is required to ensure that clinical success and economic benefits are maximised. CONCLUSIONS: The published evidence suggests positive impacts of ADS and should encourage hospitals to invest in automation, with a global strategy to improve the reliability and the efficiency of the medication process. However, one of the key findings of the current SR is the need for further data from adequately powered studies reporting clinically relevant outcomes which would allow for robust, evidence-based recommendations on the return on investment of the technologies. These studies would probably contribute to a larger adoption of these technologies by European hospitals.

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  • Further reduction in MAE rate was observed to 0.05% following ADC implementation and appropriate product labelling with barcode systems.

    “Further reduction in MAE rate was observed15 to 0.05 % following ADC implementation and appropriate product labelling with barcode systems.58”

    From Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review (2025) · cites this paper as [15]

    The Discussion reports that automated dispensing systems were associated with fewer medication errors, and the section on systems integrated with other technologies says barcode integration could provide further benefits. Neither passage reports a medication administration error rate of 0.05% or attributes that rate to appropriate product labelling with barcodes. (LLM, conf=0.84)

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  • 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”

    From Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review (2025) · cites this paper as [15]

    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

  • 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”

    From Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review (2025) · cites this paper as [15]

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Research works printed but not linked: 60

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Cited by

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Authors
Batson, S., Herranz, A., Rohrbach, N., Canobbio, M., Mitchell, S. A., & Bonnabry, P.
Affiliations
  • Systematic Review, Mtech Access, Bicester, UK
  • Hospital General Universitario Gregorio Marañón (ES)
  • Becton Dickinson (France) (FR)
  • BD Corporation, Milan, Italy
  • University Hospital of Geneva (CH)
Corresponding author
Batson, Sarah
ORCID
Venue
European Journal of Hospital Pharmacy
Publisher
BMJ
Published
2020-04-21
Volume
28
Issue
2
Pages
58-64
ISSN
  • 2047-9956 (ISSN-L)
  • 2047-9964
DOI
10.1136/ejhpharm-2019-002081
PMC
PMC7907692
OpenAlex
W3018585396
Cited by
82
References
0
Citations by year
2026: 14 · 2025: 19 · 2024: 17 · 2023: 12 · 2022: 12 · 2021: 7 · 2020: 1
FWCI
1.40
Type
journal article
Language
en
Open access
Locations
  • European Journal of Hospital Pharmacy (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Keywords
automated dispensing systems, medication dispensing, medication errors, timing of drug administration, pharmacy automation, inventory management, economic outcomes, return on investment
MeSH terms
Automation, Hospitals, Humans, Pharmacy, Pharmacy Service, Hospital, Reproducibility of Results

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