Impact of drug storage systems: A quasi-experimental study with and without an automated-drug dispensing cabinet

Abstract

Objective: To compare the costs and benefits of an automated-drug dispensing cabinet (ADC) versus traditional floor stock storage (TFSS). Design: A quasi-experimental multicenter study conducted during 2015. Setting: A teaching hospital (814 beds) equipped with 43 ADCs and a not-for-profit teaching hospital (643 beds) equipped with 38 TFSS systems, in Paris, France. Participants: All the wards of the two hospitals were included in the study. Intervention(s): ADC versus TFSS. Main Outcome Measure(s): A composite outcome composed of cost and benefits. Results: The total cost with payback period was substantially higher for the ADCs (574 006€ for 41 ADCs) than TFSS (190 305€ for 30 TFSS systems). The mean number of costly drugs and units were significantly higher for ADCs (P < 0.001). There was no significant difference in the mean number of overall drugs and units. There were significantly fewer urgent global deliveries with ADCs than TFSS units. Nurses’ satisfaction with ADCs was high and the prevalence of medication process errors related to ADCs was low. No event due to storage errors was reported for ADCs and nine events were reported for TFSS units. On the contrary, informatic-related events increased with the use of ADCs, as expected. Conclusions: Overall, ADCs are well-established in wards and are particularly appreciated by nurses. A significant difference in the initial investment cost was confirmed, but it must be adjusted over time. This difference is offset in the long-term by gains in preparation time and fewer medication process errors, securing the medication process.