JGIM: eRx assists medication adherence
People who receive medical care in an integrated healthcare system with EHRs linked to its own pharmacy system more often filled and collected new medication prescriptions for diabetes, cholesterol and high blood pressure medications than do people who receive care in a non-integrated system, according to a study published online in the Journal of General Internal Medicine.
The study examined pharmacy dispensing records of 12,061 men and women with an average age of 59 for 18 months in 2007 and 2008. The dispensing records of Kaiser Permanente Colorado examined whether they had filled new medications for high blood pressure, diabetes and high cholesterol.
The researchers found that only 7 percent of the people did not get their new prescriptions for blood pressure medication filled, 11 percent failed to pick up new prescriptions for diabetes medication and 13 percent failed to collect new prescriptions for cholesterol-reducing medication.
Previous research of patients in non-integrated health systems found that primary non-adherence, when new prescriptions are not filled and collected, is as high as 22 percent, according to lead author Marsha Raebel, PharmD, an investigator in pharmacotherapy with the Kaiser Permanente Colorado Institute for Health Research and with the University of Colorado School of Pharmacy in Denver.
“However, primary non-adherence research conducted in non-integrated systems likely overestimates the percentage of patients who do not have their prescriptions filled,” the authors wrote. “This is because, in a non-integrated system, medication orders from one organization must be linked with pharmacy claims from a different organization. Pharmacy claims databases do not include information on patients who never pick up their first prescription, nor do they contain information on patients who paid cash for their prescription.”
In contrast, within an integrated delivery system, medication orders can be directly linked to prescriptions filled within the same system, thereby including information on patients who do not pick up their first prescription, asserted the authors.
“Having EHR medication order entry linked to pharmacy dispensing information makes it much easier for clinicians and researchers to identify patients who are not getting their new prescription orders filled,” they concluded. “The next step is to better understand what the barriers are to people picking up the medications their doctors have prescribed to help them manage diabetes and heart disease.”
The study examined pharmacy dispensing records of 12,061 men and women with an average age of 59 for 18 months in 2007 and 2008. The dispensing records of Kaiser Permanente Colorado examined whether they had filled new medications for high blood pressure, diabetes and high cholesterol.
The researchers found that only 7 percent of the people did not get their new prescriptions for blood pressure medication filled, 11 percent failed to pick up new prescriptions for diabetes medication and 13 percent failed to collect new prescriptions for cholesterol-reducing medication.
Previous research of patients in non-integrated health systems found that primary non-adherence, when new prescriptions are not filled and collected, is as high as 22 percent, according to lead author Marsha Raebel, PharmD, an investigator in pharmacotherapy with the Kaiser Permanente Colorado Institute for Health Research and with the University of Colorado School of Pharmacy in Denver.
“However, primary non-adherence research conducted in non-integrated systems likely overestimates the percentage of patients who do not have their prescriptions filled,” the authors wrote. “This is because, in a non-integrated system, medication orders from one organization must be linked with pharmacy claims from a different organization. Pharmacy claims databases do not include information on patients who never pick up their first prescription, nor do they contain information on patients who paid cash for their prescription.”
In contrast, within an integrated delivery system, medication orders can be directly linked to prescriptions filled within the same system, thereby including information on patients who do not pick up their first prescription, asserted the authors.
“Having EHR medication order entry linked to pharmacy dispensing information makes it much easier for clinicians and researchers to identify patients who are not getting their new prescription orders filled,” they concluded. “The next step is to better understand what the barriers are to people picking up the medications their doctors have prescribed to help them manage diabetes and heart disease.”