Identification and safe storage of look-alike, sound-alike medicines in automated dispensing cabinets

Objectives Automated dispensing cabinets (ADCs) are used in hospitals to improve medication safety and decrease costs. However, ADCs do not completely eliminate the risk of mistakes between look-alike, sound-alike (LASA) medicines. The aim of this study was to identify the characteristics of LASA medicines and determine the factors related to their safe storage in ADCs. Methods The medication selection of one hospital pharmacy's ADC located in an intensive care unit was observed. The study consisted of five parts: a determination of criteria to identify LASA medications, an analysis of an ADCs' inventory reports, assessment of the storage of identified LASA medicines, a visual observation of the medicine packages stored in the same storage compartment and qualitative analysis of the medication-use process from prescribing a medicine to removing it from an ADC. Results Approximately 70% (n=355/488) of the ADCs selection had a LASA risk with at least one product. Moreover, 20% (n=84/355) of the LASA medicines identified were high-alert medications. Approximately 16% (n=58/355) of the identified LASA medicines were stored unsafely close to at least one other LASA medicine. Less than 4% (n=13/355) of the LASA medicines were unsafely stored high-alert medications. Conclusions ADCs reduce the risks of LASA medication errors when used correctly, but automation can also increase them, for example, when placing multiple LASA medicines in the same storage compartment. Attention should be paid to the identification and safe storage of LASA medicines to promote safe use of ADCs in hospitals.