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E-Prescribing, EHR Use May Decrease Medication Non-Adherence

E-prescribing reduced medication non-adherence by 16 percent in a recent study.

By Sara Heath

E-prescribing and physician EHR use may be the key to reducing medication non-adherence, according to a study published in JAMA Dermatology.

The study, led by researcher Adewole S. Adamson, MD, investigated the frequency of medication non-adherence among patients to received electronic prescriptions via physician EHR use versus those who received paper versions.

Adamson and the research team conducted a retrospective analysis of 4,318 prescriptions written for 2,496 patients between January, 2011, and December, 2013. The overall non-adherence level was 31 percent.

However, when using an EHR and e-prescribing, medication non-adherence was 16 percent lower, measuring at 15 percent.

The research team found that paper prescriptions did serve the patient better immediately following a physician’s appointment. Within the first four days following the initial visit, patients with paper prescriptions had lower rates of medication non-adherence. After that, patients receiving e-prescriptions had lower rates of medication non-adherence.

“Although this study was not designed to establish a cause, it is possible that having a paper prescription served as a tangible reminder for patients to fill and pick up their prescription in the short term,” Adamson and his research team explained. “However, in the longer term, lost or misplaced paper prescriptions could have led to a diminished likelihood of full adherence.”

These results may be critical, the researchers asserted, because of the negative health implications that medication non-adherence may have.

According to Adamson, patients who do not take their prescribed medications may allow chronic conditions to worsen. Medication non-adherence is also an extremely expensive problem, costing the industry millions annually.

Overall, Adamson’s findings that e-prescribing may help improve medication non-adherence is a positive step, especially considering federal requirements for the EHR functionality. Because providers are required to issue electronic prescriptions to a number of patients, they may help improve medication non-adherence as well.

“Electronic prescribing has become one of the major criteria to evaluate meaningful use of electronic health records by health care professionals,” the researchers wrote. “In this study, we demonstrated that e-prescribing is associated with reduced rates of primary nonadherence.”

E-prescribing is required under both Stage 2 and Stage 3 Meaningful Use. According to meaningful use rules, eligible providers must use Certified EHR Technology (CEHRT) to transmit electronic prescriptions and successfully attest this measure to the program.

Eligible clinicians participating in the Merit-based Incentive Payment System (MIPS), a part of the Quality Payment Program, will also have to focus on e-prescribing. The program requires eligible clinicians to transmit an electronic prescription for at least one unique patient during the first reporting year, which starts January 1, 2017.

The results of Adamson’s study may indicate that these measures indeed have a positive effect on patient care, proving their importance in both federal programs. This information is also critical because federal programs may have spurred the growing adoption of EHR e-prescribing.

Going forward, providers may consider integrating more electronic prescriptions into their clinical workflows, Adamson and colleagues suggested. It will also be important for industry experts to explore patient motivational factors behind this trend.

“As the health care system transitions from paper prescriptions to directly routed e-prescriptions, it will be important to understand how that experience affects patients, particularly their likelihood of filling the prescriptions,” he concluded.

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