Effectiveness of Pharmacy Automation Systems Versus Traditional Systems in Hospital Settings: A Systematic Review

摘要

Medication errors (MEs) in hospital settings remain a significant global healthcare challenge, resulting in adverse patient outcomes, increased healthcare costs, and reduced operational efficiency. Traditional pharmacy systems (TPS) are particularly vulnerable to human error, inefficient inventory management, and workflow bottlenecks. While pharmacy automation systems (PAS) have emerged as a potential solution, there is a notable gap in the literature regarding comprehensive comparative studies between PAS and TPS across multiple outcomes and settings. This systematic review addresses this gap by evaluating the comparative effectiveness of PAS versus TPS in hospital settings, focusing on MEs, operational efficiency, cost-effectiveness, and patient outcomes. We conducted a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed and Cochrane Library databases for studies published between 2010 and June 2024 that directly compared PAS with TPS in hospital settings. The review examined various PAS technologies, including centralized pharmacy robots, automated dispensing cabinets (ADCs), and hybrid systems incorporating centralized and decentralized technologies. Of 1,085 studies initially identified, 32 met the inclusion criteria for comprehensive analysis. The overall mean effect size was 0.505 (95% confidence interval (CI): 0.487 to 0.523), indicating a moderately positive effect of PAS implementation. Key findings demonstrated that PAS significantly reduced MEs, particularly in automated dispensing systems (ADS) and computerized physician order entry (CPOE) systems. While initial implementation costs were substantial, long-term operational costs were significantly lower due to reduced labor requirements and medication wastage. Workflow efficiency improvements enabled pharmacists to dedicate more time to clinical activities. Patient outcomes improved through enhanced medication safety and reduced adverse drug events. This review provides robust evidence supporting PAS implementation in hospitals. It demonstrates that despite significant initial investment requirements, the long-term benefits in error reduction, operational efficiency, and patient safety justify implementation. Future research should focus on detailed cost-benefit analyses across various hospital settings and assessments of staff satisfaction to optimize implementation strategies.