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Prescription Adherence

Is Prescribing Method Linked to Medication Adherence?

Adherence to prescribing instructions, which includes the patient’s intention to fill and pick up prescriptions, are associated with poorer clinical outcomes. Underuse of prescriptions is a concern and encompasses primary nonadherence, which is defined as the rate at which patients fail to fill and pick up new prescriptions.

Electronic prescribing (e-prescribing) is known to increase coordination of care and decrease errors. A recent study sought to determine whether e-prescribing affects the rate at which patients fill (primary adherence) or do not fill (primary non-adherence) their new prescriptions. Authors note that it may seem intuitive that primary adherence would increase by removing the responsibility of the patient to deliver a prescription to the pharmacy. However, the results of the few studies that have examined this issue have shown mixed results regarding the use of e-prescriptions; some showed increased primary adherence, others showing decreased primary adherence, and still others showing no difference. In the present study, the researchers reviewed the records of 2,496 patients with a highly subsidized pharmaceutical benefit plan seen at the dermatology clinic of a county hospital. Primary non-adherence was defined as not filling and picking up all dermatologic prescriptions within 1 year of the prescription date. The results showed that overall there was a 31.6% rate of primary nonadherence. The risk of primary non-adherence was 16 percentage points lower among patients given an e-prescription than patients given a paper prescription. One other notable finding was that there was a decrease in the rate of primary nonadherence when patients were given between 1 and 3 prescriptions, but an increase in primary nonadherence if they were given more than 3 prescriptions. The authors conclude that e-prescribing is associated with reduced rates of primary non-adherence.


Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: January 23, 2017

Source:  JAMA Dermatology
Adapted from the original article.

[Image: Shutterstock]

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