Approaches to outpatient pharmacy automation: A systematic review

Abstract

Purpose To systematically review, summarise and evaluate the evidence on the effectiveness of automation systems in the outpatient and community settings. Methods A literature search was performed using PubMed, Embase, Cochrane Library and CINAHL databases. A pre-defined search strategy focusing on the context of implementation, function and automation was used to identify articles published over the past decade. Two researchers independently screened the search results sequentially by title, abstract and full text using pre-defined inclusion/exclusion criteria. A third researcher was consulted to resolve disagreements. Data extraction and quality assessment were performed using a standardised form. Results Thirteen references were selected for data extraction, of which most were conducted in Europe and North America. Improvement in medication safety was most commonly reported, with findings of up to 37% reduction in medication-related reportable occurrences. Manpower requirements were found to decrease by 0.3-1.4 full-time equivalents and productivity increased by ∼4 items per person/hour. Patient waiting time and prescription filling time also decreased by 17-20 s (from an average of 19-49 s), but no reductions in workload or time savings were felt by staff. While the perception of work stress decreased, job satisfaction remained unchanged. Significant cost savings and an increase in over-the-counter sales were also noted post-automation. Conclusion Implementing pharmacy automation technologies in an outpatient or community pharmacy setting may reduce medication errors, increase productivity and save costs but does not affect staff satisfaction. However, the available literature remains patchy and more research in this area is needed.