Automation In Medication Management: Supporting Pharmacists' Engagement In Clinical Activities

Introdução: Patient safety and cost-effectiveness are fundamental in healthcare, and optimizing the medication-use process to ensure safety, efficacy, and appropriateness of pharmacotherapy has become critical. In hospital settings, medications are resources to streamline therapy across wards and support patient recovery. However, factors such as aging and critical conditions increase the complexity of pharmacotherapy, heightening the risk of polypharmacy, potentially inappropriate medications (PIMs), and adverse drug reactions. Structured prescribing frameworks (e.g., STOPP/START criteria) help mitigate those risks, yet manual medication management remains time-consuming and prone to error, compromising both workflow efficiency and patient safety. Nevertheless, automated solutions can transform the medication-use process, positioning pharmacists at the center of clinical decision-making and interventions. Objetivo: To evaluate the perspectives for clinical pharmacy practice focusing on automation systems’ reduction of pharmacists’ workload to enabling greater dedication to clinical practices. Métodos: A systematic search of PubMed and Scopus was conducted using keywords such as "automated dispensing systems," "pharmacist interventions," "medication errors," "STOPP/START Criteria," and "clinical pharmacy." Studies published between 2020-2025 were screened for relevance. Articles focusing on hospital settings and pharmacist-driven clinical outcomes were included. Resultado e Conclusão: A study involving elderly patients in different levels of healthcare analyzed 6,003 prescriptions. It found that 73.1% of prescriptions were inappropriate, with polypharmacy highly prevalent at 91.5%. Individuals with polypharmacy exhibited a higher frequency of at least one PIM prescribed. Although this reflects the prescribing stage, medication management within a hospital environment is very complex. In the included articles, automation solutions such as PillPick, Barcoding and different types of automated drug dispensating systems (ADDs) have shown significant reduction in medication errors. While prescribing errors remain less directly addressed, ADDs have shown consistent improvements in safety and quality of care by generating fewer errors in dispensing, and also allowing pharmacists to focus on clinical activities (e.g., prescription review, medication reconciliation, and patient monitoring). Notably, the integration of multiple automation components across the medication workflow with ADDs provides better benefits rather than ADDs in isolation. Nonetheless, from a financial point of view, costs were reduced in decentralized systems mainly in high-expense units, but no evidence was available whether savings can happen in smaller units. Although the included studies were heterogeneous in design and setting, limiting generalizability and leaving uncertainty regarding cost savings and prescribing-error reduction in smaller hospital units, the observed time savings remain a relevant benefit in clinical practice.