Utilization and Implementation of Automated Dispensing Cabinets in Hospitals across Saudi Arabia: A National Cross-sectional Survey

Abstract Background: Automated dispensing cabinets (ADCs) are widely used medication-use technologies designed to improve medication safety, enhance inventory control, and optimize pharmacy and nursing workflows in hospital settings. As healthcare systems increasingly adopt digital solutions, ADCs have become a core component of modern medication management. However, switching to an ADC system presents several operational and technical challenges that must be addressed in advance. Understanding barriers related to system interoperability, staff training, regulatory compliance, and ongoing performance evaluation is essential to support successful ADC implementation and to maximize the benefits of this technology in improving efficiency, medication safety, and patient care outcomes. Objectives: The objectives of this study were to measure ADC utilization across hospitals in Saudi Arabia, examine variations in system implementation, and identify factors that facilitate the successful integration of ADCs within hospital workflows. Materials and Methods: A cross-sectional national scoping survey was conducted using an online structured questionnaire distributed to pharmacy professionals involved in ADC implementation, operation, or oversight across all five regions of Saudi Arabia. The survey included demographic items, hospital characteristics, ADC utilization measures, Likert scale statements, and open-ended questions. Descriptive and inferential statistics were performed using Statistical Package for the Social Sciences version 20. Ethical approval was obtained from the Institutional Review Board at King Saud University. Results: The study achieved a 90.3% response rate, with participation from all regions. Approximately 52.3% of hospitals were using ADCs, 35.4% had not implemented them, and 12.3% reported “don’t know” regarding their ADC status. Among hospitals with ADCs, 33.8% had more than 20 units installed, and 49.2% had integrated them with their Hospital Information System. Key facilitators of successful adoption included staff education (68%), interoperability with existing systems (59%), and leadership support (53%). Major barriers included high cost (61%) and lack of financial support (56%). Conclusions: The implementation of ADCs in Saudi hospitals represents a critical step toward advancing medication-use technology. Findings emphasize that successful implementation requires not only technical integration but also strategic planning, investment, and organizational support. Strengthening national guidance for ADC deployment may help unify practice, improve medication management, and enhance patient safety across the healthcare system.