Orlando, FL—Now that e-prescribing has become the norm, not the exception, thanks to the Medicare Improvements for Patients and Providers Act and Meaningful Use programs, what effect has it had on patient outcomes?

That is the question addressed in a recent article published ahead of print by the journal Medical Care. University of Central Florida–led researchers examined the effect of e-prescribing on emergency visits or hospitalizations for diabetes-related adverse drug events (ADEs), including hypoglycemia.

The prospective, observational cohort study with patient fixed effects looked at records of Medicare fee-for-service beneficiaries from 2011 to 2013. The focus was on 3.1 million patients >66 years who had diabetes mellitus, were enrolled in Medicare Part D, and had been prescribed at least 90 days of antidiabetic medications.

E-prescribing was measured as the percentage of all prescriptions patients received that were transmitted electronically to pharmacies. The occurrence of an emergency department (ED) visit or hospitalization for hypoglycemia or diabetes-related ADEs were the primary outcome measures.

Overall, 21 ADEs per 1,000 beneficiaries occurred with 75% or more medications e-prescribed; beneficiaries with lower e-prescribing levels had significantly higher numbers of ADEs. 

“We found a robust association between the greater use of electronic prescriptions in the outpatient setting and the lower risk of an inpatient or ED visit for an ADE event among Medicare beneficiaries with diabetes in our adjusted analysis” study authors conclude. “At the e-prescribing threshold of 75% and above, significant reductions in ADE risk can be seen.”

Researchers caution that the study was observational; as an observational study, the results show an association, but do not prove causation.

More than 70% of physicians are now e-prescribing using an electronic health record on the Surescripts network. That increased substantially from 7% in December 2008 when the Medicare Improvements for Patients and Providers Act was passed and 24% when the Medicare and Medicaid EHR Incentive Programs began.
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