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Automated unit dose dispensing systems producing individually packaged and labelled drugs for inpatients: a systematic review
  1. Kaisa Hänninen1,2,
  2. Hanne Katriina Ahtiainen2,3,
  3. Eeva Maria Suvikas-Peltonen4,
  4. Ann Marie Tötterman2
  1. 1Hospital Pharmacy, Central Finland Hospital Nova, Jyvaskyla, Finland
  2. 2Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
  3. 3HUS Pharmacy, Helsinki University Hospital, Helsinki, Finland
  4. 4Hospital Pharmacy, Satasairaala Central Hospital, Pori, Finland
  1. Correspondence to Dr Kaisa Hänninen, Hospital Pharmacy, Central Finland Hospital Nova, Jyvaskyla, Finland; kaisa.hanninen{at}ksshp.fi

Abstract

Objectives Pharmacy automation is increasing in hospitals. The aim of this systematic review was to identify and evaluate the literature on automated unit dose dispensing systems (UDDS) producing individually packaged and labelled drugs for inpatients.

Methods The search was conducted on eight electronic databases, including Scopus, Medline Ovid, and Cinahl, and limited to peer reviewed articles with English abstracts published 2000–2020. Studies were included in the review if drug dispensing was performed by an automated UDDS where individually packaged and labelled unit doses were subsequently assembled patient specifically for inpatients. All outcomes related to UDDS functionality were included with specific interest in medication safety, cost-efficiency and stock management. Outcomes were categorised and results synthesised qualitatively.

Results 664 publications were screened, one article identified manually, resulting in eight included articles. Outcomes of the studies were categorised as medication administration errors (MAEs), dispensing errors, costs and cost-effectiveness. Studies showed that automated UDDS reduced significantly MAEs of inpatients compared with traditional ward stock system (WSS), especially when UDs were dispensed patient specifically by unit dose dispensing robot. Patient specific drug dispensing with automated UDDS was very accurate. Of three different automated medication systems (AMSs), patient specific AMS (psAMS) was the most cost-effective and complex AMS (cAMS) the most expensive system across all error types due to the higher additional investments and operation costs of automated dispensing cabinets (ADCs). None of the studies investigated the impact on the medication management process such as efficiency, costs and stock management as primary outcome.

Conclusions UDDS improved patient safety. However, automation is a costly investment and the implementation process is complex and time consuming. Further controlled studies are needed on the clinical and economical outcomes of automated UDDS to produce reliable knowledge for hospital decision makers on the cost-benefit of the investment and to support decision making.

  • automated unit dose dispensing system
  • automated medication system
  • unit dose dispensing robot
  • inpatient
  • medication administration errors
  • cost-effectiveness
  • medication stock management

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

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