Intravenous compounding robots in pharmacy intravenous admixture services: a health technology assessment

Abstract Background This study was performed to conduct a health technology assessment of intravenous compounding robots and provide the currently available best evidence for hospital decision-makers. Methods A comprehensive search of relevant professional health technology assessment websites and electronic databases (Embase, PubMed, The Cochrane Library, CNKI, VIP, CBM, and Wanfang Database) was conducted from inception to 11 August 2020. Two reviewers independently screened literature according to the inclusion and exclusion criteria and extracted data. The results were reported by qualitative description because of heterogeneity in the characteristics of the data in the included studies. Results Forty studies were included: 2 health technology assessments, 24 control studies (6 randomized controlled trials, 13 non-randomized contemporaneous controlled trials, and 6 non-randomized historical controlled trials), 12 non-controlled studies (11 single-arm studies, 1 investigation report), 1 qualitative study (in-depth interview), and 1 economics research. Effectiveness: The robots improved the production efficiency compared with usual/manual preparation; however, the intravenous preparation process requires further optimization. Additionally, robots reduced the incidence of medicine residues, preparation errors, and preparation failures. The accuracy and solution properties of intravenous admixture medicines were satisfactory, and the robots also contributed to error recognition. Safety: The robots reduced product pollution and environmental pollution, but vigilance is still required to ensure that pollution stays low. The robots also reduced the incidence of health damage to technicians. Economy: The robots reduced material costs in these studies; however, whether they can reduce labor costs remains unclear. Social suitability: Technicians had a high degree of satisfaction with the robots, but few relevant studies focused on this aspect. Conclusion Intravenous compounding robots have certain advantages in terms of safety, effectiveness, economy, and social adaptability. High-quality and large-sample randomized controlled trials or well-designed observational studies are still needed to evaluate such robots, especially in terms of economic and social suitability.