MedicalResearch.com Interview with:
Adewole S. Adamson, MD, MPP
Department of Dermatology
The University of North Carolina at Chapel Hill
Chapel Hill, NC
MedicalResearch.com: What is the background for this study?
Response: As the United States has moved to increasing levels of electronic medical record keeping, electronic prescribing has become an important part of improving the quality of care and patient experience. E-prescribing increases co-ordination between pharmacist and physician and decreases prescription errors. However, it is less certain whether e-prescribing affects patient primary adherence to medications, meaning whether or not a patient will fill and pick up their medication at the pharmacy. Although it may seem intuitive that primary adherence would increase by removing the patient from the prescription-to-pharmacy routing process, there have been few studies directly comparing primary adherence of patients given traditional paper prescriptions versus e-prescriptions.
MedicalResearch.com: What are the main findings?
Response: A total of 4318 prescriptions were written for 2496 patients. The overall rate of primary nonadherence was 31.6% (n = 788). Based on multivariable analysis, the risk of primary nonadherence was 16 percentage points lower among patients given an electronic prescription (15.2%) than patients given a paper prescription (31.5%).
Primary nonadherence decreased with increasing age, then increased in elderly patients 70 years and older. When patients were given more than 3 prescriptions their likelihood of filling all their prescriptions declined. In this population, patients identifying English as their primary language had the highest rate of primary nonadherence compared with non-English speakers.
MedicalResearch.com: What should readers take away from your report?
Response: Patients are more likely to fill and pick up medications if they are prescribed in an electronic format. Patient given more than 3 prescriptions were more likely to abandon some or all of their prescriptions at the pharmacy.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Steps should be taken to better understand why primary nonadherence happens and how it can be improved.
MedicalResearch.com: Is there anything else you would like to add?
Response: During the first 4 days from the clinic visit, patients with paper prescriptions had a higher rate of full adherence than electronic prescriptions. 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. However, in the longer term, lost or misplaced paper prescriptions could have led to a diminished likelihood of full adherence.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Adamson AS, Suarez EA, Gorman AR. Association Between Method of Prescribing and Primary Nonadherence to Dermatologic Medication in an Urban Hospital Population. JAMA Dermatol. Published online October 26, 2016. doi:10.1001/jamadermatol.2016.3491
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