ISSN: 2320-5407 Int. J. Adv. Res.

10(04), 244-248

Journal Homepage: -www.journalijar.com

Article DOI:10.21474/IJAR01/14540
DOI URL: http://dx.doi.org/10.21474/IJAR01/14540

RESEARCH ARTICLE
AUTOMATION OF DRUG DISPENSING: FEEDBACK FROM A HOSPITAL PHARMACY

Enneffah Wafaa, El Wartiti Mohammed Adnane, Adouani Badr, Tadlaoui Yasmina, Bennana Ahmed,
Cherkaoui Nawal and Lamsaouri Jamal
Mohammed V University of Rabat, Faculty of Medicine and Pharmacy, Rabat, Morocco.
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Manuscript Info Abstract
……………………. ………………………………………………………………
Manuscript History Background: Ensuring drug circuit security is the ultimate goal for
Received: 15 February 2022 hospital pharmacists. Alarmed by the excessive drug consumption at its
Final Accepted: 18 March 2022 on-duty pharmacy, Mohammed V Military Teaching Hospital of Rabat
Published: April 2022 (Morocco) installed a centralized automation for drugs dispensation.
This experience is expected to be decentralized to all care units.
Key words:-
Automation, Drugs Dispensation, Our study purpose is to evaluate automation’s impact on
Advantages, Constraints, Motivation, pharmaceutical drug management, and then to determine limits to be
Hospital Pharmacy improved.
Resources and procedures: We analyzed, over a period of 10 months,
data from the database of the automated distribution system deposited
at our on-duty pharmacyin order to determine its usage profile. We also
evaluated through a questionnaire the point of view of our 13 pharmacy
technicians toward drug dispensing automation.
Results: Over the study period, we got the following results:
- 5446 transactions were accomplished and 8864 drugs unit were
dispensed;
- Parenteral route drugs are the most delivered (67%);
- Anti-inflammatories and analgesics are the most required (26%),
followed by the anti-infective drugs (25%);
- Young technicians did more transactions (63%) than the elders did
(37%);
- According to pharmacy technicians, main automation’s
advantages are saving time in locating medications (8/13) and limiting
drugs errors (5/13). Otherwise, main constraints are the irregular
machine replenishment (10/13) and the reduced capacity for storing all
medications (6/13), specially refrigerated and oversized ones.
Conclusion: Automation of drug delivery offers many advantages.
However, there are still limits to be improved before it’s
decentralization to all care units.

Copy Right, IJAR, 2022,. All rights reserved.

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Introduction:-
Ensuring the quality and security of the drug circuit is the ultimate goal for hospital pharmacists. In this sense,
automated drug dispensing system offers many advantages: registered drug distribution, optimized stock
management and traceability with less expiration and drug errors, stock rationalization, remote monitoring,
economic gains (CADTH, 2010; Lehnbom, 2013)…

Corresponding Author:- El Wartiti Mohammed Adnane 244

Address:- Mohammed V University of Rabat, Faculty of Medicine and Pharmacy, Rabat,
Morocco.
ISSN: 2320-5407 Int. J. Adv. Res. 10(04), 244-248

Alarmed by the excessive drug consumption at its on-duty pharmacy, Mohammed V Military Teaching Hospital
installed a centralized automation for drugs dispensation. This experience is expected to be decentralized to all care
units.

The purpose of our study is to evaluate the impact of automation on pharmaceutical drug management, and then to
determine limits to be improved.

Resources and procedures:-

In this study we analyzed, over a period of 10 months, data from the database of the automated distribution system
deposited at on-duty pharmacy of Mohammed V Military Teaching Hospital of Rabat (Morocco), in order to
determine its usage profile. We also used a questionnaire filled at the end of the study period by the 13 Pharmacy
technicians working at our hospital pharmacy (6 young and 7 seniors), in order to evaluate their point of view
toward automation.

Results and Discussion:-

Automated dispensing systems are drug storage devices that electronically dispense medications in a controlled
fashion and track medication use. Most systems require user identifiers and passwords, and internal electronic
devices track users accessing the system, track the patients for whom medications are administered, and can even
provide usage data to the hospital's financial office for the patients' bills.

Our centralized automation experience allowed us to obtain the following results:

Level and nature of use

Over the study period, 5446 transactions have been accomplished, among which 4524 were accomplished by
pharmacy technicians. The residual transactions (n=922) were mostly preventive and corrective maintenance
transactions done by computer technicians to prevent or to right mechanical or computer breakdowns. These latters
would tend to regress as pharmacy technicians are getting familiar with machine use. Otherwise, certain anomalies
could be solved more quickly through training and support, especially during the early stages of implementation
(Hyland, 2007). The detail of transactions for all profiles combined is shown on Fig 1.

Characteristics of dispensed drugs

Dispensing operations totaled 8864 units of dispensed drugs over the study period. Injection forms are the most
delivered followed by oral forms. Topical route remains negligible (Fig 2). This is consistent with the hospital
context where injectable drugs are most commonly used. As shown on fig 3, the category combining ant i-
inflammatories and analgesics is the most required (with paracetamol as the most used analgesic), followed by the
anti-infective drugs category (with amoxicillin/clavulanic acid as the most used antibiotic). These drugs categories
are the most ordered at the on-duty pharmacy by emergency and intensive care units. These lattersare known for
their considerable drug consumption at hospitals. In this wake, paracetamol is widely used due to its high tolerance,
especially for patients with compatible particular terrain (children, pregnant women, elderly patients…), same goes
for amoxicillin/clavulanic acid which is privileged for its high efficiency as a first-line empirical treatment.

Motivation
Young pharmacy technicians are more motivated than the elder ones toward automation, as young technicians did
more transactions (63%) than the elders did (37%), even if the latters were more numerous. This may be due to the
fact that juniors are more familiar with technology than seniors (Fig 4). Moreover, it is widely admitted that
perceived usefulness is related to the intention of use and usage behavior. Experiments have shown that “resistance-
to-change” phenomena are more common in seniors compared to young professionals (Chapuis, 2010; Lehnbom,
2013).

Advantages and constraints

According to the 13 pharmacy technicians, main automation’s advantages are saving time in locating medications
(8/13) and limiting drugs errors (5/13). Otherwise, main constraints are the irregular machine replenishment (10/13)
and the reduced capacity for storing all medications (6/13), specially refrigerated and oversized ones.

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To access the machine, pharmacy technicians must use a specific password. This secures the access to risky drugs
like narcotics and reduces the risk of dispensing errors, especially for high alert medications stored in the dispensing
machine secured drawers. These are composed of compartments with selective opening, and which allow the
pharmacy technician to be guided during dispensing by specifically opening the compartments containing the risky
drug and by asking the pharmacy technician to check and confirm the stock of the said drug before and after its
picking up from the compartment (CADTH, 2010; Hyland, 2007; ISMP, 2019; Lehnbom, 2013; UTMC, 2020).

Fig 1:- Transactions accomplished (n=5446).

Fig 2:- Dispensed drug units by the route of administration (n=8864).

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Fig 3:- Drug consumption by therapeutic classes (n=8864).

Fig 4:- Transactions accomplished by Pharmacy technicians (n=4524).

2867
3000

2500

2000 1657

1500

1000

500

0
Elder Pharmacy Young Pharmacy
Technicians (n=7) Technicians (n=6)
Conclusion:-
The contribution of drug dispensing machines in improving the quality and safety of care is well established.
However, in our context, there are still limits to be improved concerning machine replenishment (by accountability
and adherence to schedules), storage capacity and storage conditions (by extending the number of dispensing
machines and providing refrigerated units), without forgetting the lack of motivation among seniors (by sensitization
and support) and the occurrence of breakdowns (by training on compliance with terms of use). This would stabilize
the automated solution before its decentralizing to cover all care units. In this sense, the main advantage to reach is
permitting nurses to obtain medications for inpatients at the point of use, in order to save time and to prevent drugs
administration errors.

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Bibliographic References:-
[1] Canadian Agency for Drugs and Technologies in Health (CADTH). (2010): Automated medication dispensing
systems: A review of the clinical benefits, harms, and cost-effectiveness, Canada: 12 pages. https://www.cadth.ca/
[2] Chapuis, C., Roustit M., Bal, G., Schwebel, C., Pansu, P., David-Tchouda, S. et al., (2010): Automated drug
dispensing system reduces medication errors in an intensive care setting. Crit. Care. Med., 38(12): 2275-2281.
[3] Lehnbom, E.C., Oliver, K.V., Baysari, M.T. and Westbrook, J.I. (2013): Evidence briefings on interventions to
improve medication safety: automated dispensing systems, Australia. Centre for Health Systems and Safety
Research, 1(2): 4 pages. www.aihi.unsw.edu.au/
[4] Hyland, S., Koczmara, C., Salsman, B., Sum-Musing, E.L. and Greenall, J. (2007): Optimizing the Use of
Automated Dispensing Cabinets. CJHP., 60(5): 332-334.
[5] University of Toledo Medical Center (UTMC). (2020): Automated dispensing cabinets & override lists, USA.
Policy 3364-133 -75: 17 pages.https://www.utoledo.edu/
[6] Institute for Safe Medication Practices (ISMP). (2019): Guidelines for the safe use of automated dispensing
cabinets, USA. ISMP: 20 pages. www.ismp.org.

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