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British Journal of Healthcare and Medical Research - Vol. 11, No. 3
Publication Date: June 25, 2024
DOI:10.14738/bjhmr.113.16968.
Gobir, I. B., Niyang, M. P., Adamu, H., Agboola, S., Bello, A. A., Havila, N. O., Sanni, F. O., Otubu, S. A., & Bazira, D. (2024). Perceived
Benefits of Using Smart Lockers as Virtual Dispensing Units for Chronic Disease Medication: Healthcare Workers’ and Patients’
Perspective. British Journal of Healthcare and Medical Research, Vol - 11(3). 79-96.
Services for Science and Education – United Kingdom
Perceived Benefits of Using Smart Lockers as Virtual Dispensing
Units for Chronic Disease Medication: Healthcare Workers’ and
Patients’ Perspective
Ibrahim Bola Gobir
ORCID: 0000-0002-3640-7772
Center for Global Health Practice and Impact,
Georgetown University, Washington DC, United States of America
Mercy Piring'ar Niyang
Georgetown Global Health Nigeria,
Federal Capital Territory, Abuja, Nigeria
Helen Adamu
Georgetown Global Health Nigeria,
Federal Capital Territory, Abuja, Nigeria
Samson Agboola
Georgetown Global Health Nigeria,
Federal Capital Territory, Abuja, Nigeria
Azeez Akanbi Bello
Georgetown Global Health Nigeria,
Federal Capital Territory, Abuja, Nigeria
Nnadozie Onyinyechi Havila
Georgetown Global Health Nigeria,
Federal Capital Territory, Abuja, Nigeria
Fatimah Ohunene Sanni
Georgetown Global Health Nigeria,
Federal Capital Territory, Abuja, Nigeria
Suzzy Angmun Otubo
Savannah Health System Innovation Limited,
Federal Capital Territory, Abuja, Nigeria
Deus Bazira
Center for Global Health Practice and Impact,
Georgetown University, Washington DC, United States of America
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British Journal of Healthcare and Medical Research (BJHMR) Vol 11, Issue 03, June-2024
Services for Science and Education – United Kingdom
ABSTRACT
Chronic diseases present a significant public health challenge globally, particularly
in resource-limited settings like Nigeria. Effective management of chronic diseases
often requires regular access to medications and adherence to treatment regimens.
Smart Lockers, serving as Virtual Dispensing Units (VDU), offer a potential solution
to improve medication access and adherence among individuals with chronic
illnesses. However, little is known about the perceptions of healthcare workers
(HCWs) and patients regarding using Smart Lockers in Nigeria. This study assessed
the perceived benefits of Smart Lockers as VDU among HCWs and patients for
chronic disease medications. It explored how demographic factors influence these
perceptions. A descriptive cross-sectional research design was employed. Data
were collected from 405 HCWs and 728 patients via a structured questionnaire.
Descriptive statistics were used to analyze demographic characteristics and
perceived benefits, including means, standard deviations, and percentages.
Additionally, One-way Analysis of Variance (ANOVA) and t-test were conducted to
explore relationships between demographics and perceptions, with significance set
at p < 0.05. The results revealed that among HCWs, the perceived benefits of Smart
Lockers included reduced workload (Mean = 4.40), facility decongestion (Mean =
4.50), and decreased patient waiting time (Mean = 4.57). Patients perceived
benefits such as minimization of time spent waiting at healthcare facilities (Mean =
4.26) and reduced transportation costs associated with accessing care (Mean =
3.84) most positively. Significant variations in perceptions among HCWs and
patients were observed based on demographic factors such as gender, age, marital
status, employment status, and educational qualification. Male HCWs and patients,
as well as employed patients, tended to perceive the benefits of Smart Lockers more
positively compared to their female counterparts and unemployed patients,
respectively (p < 0.05). Additionally, patients with higher educational qualifications
expressed more favourable perceptions of Smart Locker’s benefits than those with
lower educational levels (p < 0.05). Understanding these perceptions and
demographic influences is crucial for effectively implementing and utilizing Smart
Lockers technology in healthcare settings. Tailored interventions based on these
findings can help address disparities in perceptions and enhance the acceptance
and utilization of Smart Lockers for chronic disease management in Nigeria. This
study provides significant perspectives into healthcare technology and chronic
disease management, ultimately aiming to improve healthcare delivery and patient
outcomes in Nigeria.
Keywords: Smart Lockers, Chronic diseases, Healthcare workers, Medication, Persons
Living with HIV (PLHIV), Virtual dispensing units (VDU).
BACKGROUND
Traditional care methods for chronic diseases have involved in-person visits to healthcare
facilities and healthcare providers’ offices. Often, patients seek out healthcare providers for
clinical consultations, diagnoses, prescriptions, refills, and even routine health status
monitoring done in person. This approach strains HCWs who must attend to many patients
daily, particularly in settings where resources are strained.[1] Recently, the trend has attempted
to shift the focus of healthcare service delivery from providers to patients. There has been
increased advocacy for incorporating decentralized and person-centred care in health
systems.[2] The potential for innovation to improve the quality of care and service delivery in
healthcare is enormous, be it a new concept, product, service, or care pathway that offers clear
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Gobir, I. B., Niyang, M. P., Adamu, H., Agboola, S., Bello, A. A., Havila, N. O., Sanni, F. O., Otubu, S. A., & Bazira, D. (2024). Perceived Benefits of
Using Smart Lockers as Virtual Dispensing Units for Chronic Disease Medication: Healthcare Workers’ and Patients’ Perspective. British Journal of
Healthcare and Medical Research, Vol - 11(3). 79-96.
URL: http://dx.doi.org/10.14738/bjhmr.113.16968.
advantages over current practices.[3,4] However, if it must be considered a
successful innovation, it should be usable and appealing to the target population. Globally,
efforts to improve the quality of healthcare services are hampered by insufficient budgets, an
increase in demand, and public expectations [5,6]
. This is important in achieving equitable access
to healthcare. The role of technology in enabling person-centred care cannot be
underestimated. Progress is being made in medicine and information, with communication
technology driving the digitalization of healthcare systems.[7,8] Digital health technologies offer
significant opportunities in this new era of healthcare digitalization to maximize clinical care
delivery and clinical research.[9] In addition, patients are more involved as healthcare becomes
increasingly digital. Consequently, digital healthcare solutions have become critical to keeping
up with the growing number of empowered patients making medical decisions.[10]
For example, the South African National Blood Service (SANBS) began using drones to
distribute blood to combat the continent’s high maternal mortality rate. This has allowed access
to life-saving health services within as few as 30 minutes compared to previously obtainable
using road transport, which may take days.[11] Other technological innovations include mobile
apps that offer remote access to medical information and even clinical consultations. In Nigeria,
“Omomi,” an app for pregnant women, advises mothers, intending and expectant mothers, on
how to keep track of their child’s health.[12] Similarly, a malaria-diagnosing app is undergoing
clinical trials in Uganda.[13]
Several methods of dispensing medications to patients have been explored at different times.
For instance, A study conducted in Zimbabwe describes various community-based and facility- based care models for the dispensing of ARV drugs. The study reported decentralizing services
to primary health care centres where patients can access drug pickups is a facility-based model.
In contrast, the community-based model requires patients to pick up their medications near
their residences, such as community-based organizations, malls, or community halls.[14]
The outbreak of the COVID-19 pandemic brought to bear the significance of telehealth
innovations in providing decentralized and person-centred care. In many countries, there was
increased adoption and rapid expansion of telehealth services.[4,15] In South Africa, for instance,
an innovative method of drug distribution to chronic disease patients was used during the
Coronavirus outbreak. Drugs were prepackaged and delivered to the homes to reduce the
frequency of hospital visits and exposure to COVID-19 infections.[16]
Another innovation is the Pharmacy Dispensing Unit (PDU), a remote dispensing unit with
similar features to an Automated Teller Machine. It uses robotic technology to deliver
medication on demand and allows pharmacist consultation via audio video.[17] Similar to the
PDU is the Smart Lockers, an automated medication delivery machine. It has been used to
dispense chronic disease medications such as Antiretrovirals (ARVs) and Tuberculosis (TB). De
Villers [18] described using Smart Lockers strategically placed in accessible locations such as
clinics, retail malls, pharmacies, or bus stops. To get their medication, patients can use their
cell phones to access a one-time password to unlock a compartment in the locker where their
drugs have been pre-dispensed by trained personnel. In South Africa, Smart Lockers have been
documented in dispensing ARVs and Tuberculosis (TB) medications, which allowed patients to
access prescribed drugs within minutes using an automated one-time password to access the
locker.[18] This innovation has been regarded as a massive breakthrough in the healthcare