E-Prescribing Seen as Potential First Step Toward Improving Patient Adherence
Deerfield, Ill. and Alexandria, Va. - October 15, 2007 - New research that tracked the number of prescriptions received by pharmacies before and after physicians began using electronic prescribing showed an 11 percent increase in new prescriptions filled. The research - conducted by SureScripts and Walgreens using prescriber data from IMS Health - links a physician prescribing electronically, or "e-prescribing", to more of that physician's prescriptions making it to the pharmacy.
E-prescribing is when a physician uses a computer or handheld computing device to electronically generate and send a prescription to a pharmacist's computer. E-prescribing is a more safe and efficient means of sending prescription information than handwritten, printed, faxed, or telephoned prescriptions.
"If appropriately used, e-prescribing can open up better lines of communication between all members of the healthcare team," says Allen Vaida, PharmD, FASHP, Executive Vice President of the Institute for Safe Medication Practices (ISMP). "It also can provide vital drug and patient-specific information during prescribing and ultimately help reduce the risk of adverse drug events."
The research involved a convenience sample of 100 active electronic prescribers across five states, 93 different pharmacy organizations at 14,638 locations, and over one million prescriptions. No patient data was used in the analysis. The six months of prescriber data included three months before and three months after physicians began e-prescribing. To account for seasonal influences on prescribing, activation dates spanned 19 months: from April 2005 through November of 2006. The study also controlled for variations in prescribing software by involving physicians using 15 different software vendor applications.
Prescription Counts For 100 Prescribers: Before & After E-Prescribing
3 Months Before e-Rx 3 Months After e-Rx Difference
New Prescriptions 272,103 302,616 11.21%
By reviewing a subset of the overall data (prescriptions sent to Walgreens), researchers also observed that as many, if not more, patients picked up their prescriptions when they were sent electronically to their pharmacy (i.e. as compared to handwritten, printed, faxed, or telephoned prescriptions). And while further research is needed to ascertain how electronic prescribing causes more prescriptions to be received by pharmacies and picked up by patients, experts are suggesting the study's results represent the first evidence that e-prescribing could help address prescription leakage, one part of the long-standing problems of patient adherence. Adherence defines how well a patient sticks to their drug regimen.
According to studies cited in a recent report by the National Council on Patient Information and Education (NCPIE), only about 50 percent of American patients typically take their medicines as prescribed, resulting in approximately $177 billion annually in direct and indirect costs to the U.S. economy.
"A common hurdle to adherence improvement has been the drop off that occurs at the handoff of the prescription from consumers to the pharmacy," said Ray Bullman, NCPIE Executive Vice President. "Eprescribing ameliorates a myriad of factors that challenge consumers' getting their prescriptions to the pharmacy. That's an important contribution."
The first step in assessing patient adherence is determining whether the patient picks up the prescription at all. Industry experts estimate that up to 20 percent of all new prescriptions go unfilled, and the estimated rates for prescription refills that are not picked up are even higher.