ICPA cautions introduction of remote dispensing machines for chronic medication
It was recently announced that South Africa is set to receive its first batch of ATM-like pharmacy dispensing machines for patients on chronic medication. These remote automated dispensing units, or “RADU’s”, will dispense medications (much like an ATM dispenses money) to customers who have entered their secret pin number and have scanned their bar-coded ID books.
Consumers have responded positively to the introduction of this convenient technology, but pharmacists are concerned about the safety aspects of the machines.
Remote automated dispensing units are already being utilised around the world where they predominantly service remote areas that do not have access to a pharmacy. The machines have also been applied in correctional facilities that do not operate full service in-house pharmacies.
In the South African context it is anticipated and speculated that the introduction of the machines is part of a move to take some of the pressure off the healthcare system.
However, Mogologolo Phasha, Chairman of the Independent Community Pharmacy Association (ICPA) explains that whilst the concept of the RADU is a sound one – allowing people improved access to medication – the ICPA is very concerned about the drawbacks presented by these automated dispensing machines.
“There are definite applications where RADU’s would benefit the South African public,” says Phasha.
“For example, where access to a pharmaceutical service is compromised due to a remote location. Typically, there could also be an argument to install remote dispensing machines at government hospitals to relieve dispensing burden.”
However, is it really in the patients’ best interests to talk to a machine when it comes to something as important as chronic medications and health care? Phasha argues that by forgoing the need to go into a pharmacy, patients will miss out of the patient/pharmacist interaction which offers a more personal, interactive and holistic approach to care than a virtual dialogue platform can offer.
According to the ICPA, face to face counselling is the gold standard and in this way the pharmacist is able to engage with the patient on numerous levels and is also able to monitor the patient more closely – helping to manage side effects and counsel patients on taking multiple medications effectively and safely.
“By accessing medications through a remote automated dispensing unit, patients miss out on the more comprehensive and personalised service that is offered by an independent community pharmacy,” says Phasha. “Besides dispensing medicines and offering free advice on medication, many local independent community pharmacies offer a wide range of clinic services and pharmacists are highly qualified health care professionals who train for years to become experts in medicines and in offering advice on a patient’s wellbeing.”
Other drawbacks or issues with regards to the automated dispensing of medicines foreseen by the ICPA include:
- The ongoing servicing and effective maintenance of these hi-tech machines may be problematic – especially given the potential for vandalism, particularly in outlying areas;
- Keeping the RADU machines stocked with the right medications in sufficient amounts at all times will be a challenge;
- The user-friendliness of these units – especially in remote areas where customers may not be fully literate or tech-savvy which may result in misunderstandings and compromised care.
“In addition to this, the Minimum Standards for the operation of remote automated dispensing units has not yet been implemented by the South African Pharmacy Council,” explains Phasha, “We expect extensive checks and balances to be implemented to ensure the safe implementation of this technology.”
“Whilst the ICPA recognises that the improvement of health care accessibility in rural, remote, and outlying communities is an ongoing priority, and whilst the pharmacy profession is happy and willing to embrace technological development, it will never be at the expense of the patient.”
“The ICPA maintains that whilst there are applications where a RADU would be effective and useful it should not replace a brick and mortar pharmacy where patients receive a far more comprehensive and personalised service – further ensuring their ongoing health,” concludes Phasha.