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Increased Physician EHR Use Tied to Medication Adherence

By helping physicians gain insights about certain chronically ill populations, EHRs can help increase medication adherence.

By Sara Heath

Increased physician EHR use could help alleviate the problem of medication non-adherence from chronic disease patient populations, recent research suggests.

A team of researchers observed the effect of physician EHR use and patient-centered medical homes on medication adherence for chronically ill patients. De Leon et al. hypothesized that physician EHR use would enable the pinpointing of certain patient population needs and adjusting of clinical workflows.

“Several primary care practice models have been hypothesized to improve health outcomes for patients with chronic conditions — this includes the adoption of an electronic health record (EHR) as a means to assess a practice’s patient population and proactively intervene,” the researchers stated in the study.

The researchers took patient populations dealing with hypertension, diabetes, or a combination of both diseases and categorized them as visiting one of New York City’s Primary Care Information Project (PCIP) facilities or not at all. PCIPs are facilities equipped with health technologies and EHRs intended to increase care coordination and population health.

The researchers found that those patients who attended PCIPs had greater medication adherence than those who did not. However, this was not the most significant finding of the study. Throughout the study, several of the PCIPs were on an initiative to decrease medication copays. The researchers found that this practice has a more profound effect on medication adherence than the use of EHRs did.

“Provider participation in the PCIP was associated with greater improvements in the proportion of adherent members between 2 time points for some groups,” the researchers reported. “However, these associations were generally nonsignificant, and the magnitude and significance of the improvements were diminished when practices participating in a program providing reduced prescription co-pays to members with chronic conditions were excluded from the analyses.”

This means that the differences between PCIP and non-PCIP patient medication adherence rates were not significant until the cost of copay was taken into account. Those patients who had a lower copay were more likely to get their prescriptions filled.

Although the research did not reveal that EHRs make a significant impact on medication adherence, the researchers maintained that the PCIP initiative in New York helps increase overall care by educating practices on how to effectively use EHRs to improve practice workflow.

“[T]he PCIP has facilitated quality improvement and promoted population health by educating providers on quality improvement and helping them to redesign workflows to use their EHRs more effectively at the point of care,” the researchers stated.

These results indicate that medication adherence is a nuanced issue that may require several solutions:

Improving medication adherence is a complex issue that requires further research and evaluation. In addition to lowering patient costs, models in which improved medication adherence has been observed include use of automated calling systems to conduct patient outreach and use of pharmacy personnel to counsel patients on their medications as part of the team-based approach within the PCMH setting.

Ultimately, the researchers suggest that increased patient engagement, be it through EHRs, automated call systems, or patient outreach, is an integral part of improving chronic care. Furthermore, patients need to be instructed in the benefits of medication adherence and need to be shown how being adherent can be advantageous for them.

“Health information systems and practice support in the primary care setting, coupled with patient incentives, can significantly improve patient quality of care and potentially improve patient engagement in managing their chronic conditions beyond the office visit,” De Leon et al. concluded.

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