May 30, 2012

Increase in E-Prescribing Isn’t Reducing Pharmacists’ Intervention Rate Significantly

Arlington, VAMore than half of office-based physicians e-prescribed in 2011, a dramatic increase from 3 years before when only 10% used electronic prescribing, according to the operator of the nation's largest e-prescription network.

Surescripts noted that 317,000 office-based physicians, or 58%, now actively e-prescribe, with 570 million prescriptions were routed electronically last year. That was 75% more than the 326 million e-prescriptions in 2010. By the end of 2011, about 36% of prescriptions were sent electronically compared to 22% at the same time the year before.

E-prescribing, Surescripts points out in the recently released “2011 National Progress Report on E-Prescribing and Interoperable Health Care,” “is built around three key components that allow pharmacists, prescribers and pharmacy benefit managers (PBMs) to obtain maximum efficiency, significant cost savings and value.”

The benefits have not been as great for community pharmacists who find they still have to make so many callbacks to assure the accuracy of the prescriptions. A study released earlier this year by the Research in Social and Administrative Pharmacy journal found that, “When comparing e-prescribing with handwritten prescriptions requiring interventions, no significant differences existed. Results suggest that pharmacists must intervene on e-prescriptions as at the same rate as handwritten prescriptions.”

The study out of the University of Arizona College of Pharmacy used an observational prospective design examining data from two community chain grocery store pharmacies. The primary outcome was number of interventions for each prescription conveyance type, such as:

* the type of medication(s) involved in the intervention;
* how the pharmacist was alerted to the potential problem, reason for the intervention;
* pharmacists' actions based on the intervention, time spent during the resolution of the intervention; and
* costs based on pharmacy personnel time.

During the 13 days of data collection, pharmacists reviewed 1,678 new prescriptions and intervened on 9.1%, or 153. The time to perform all interventions was 11 hours and 58 minutes, or an average of 4.9 minutes per intervention.

The most common reasons for pharmacists' intervention on e-prescriptions were excessive quantity/duration, 18.2%, and violating legal requirements, 18.2%. While the percentages of interventions were significantly different between e-prescribing, 11.7%, and both faxed (3.9%) and verbal (5.1%) orders, there was relatively little statistical difference in the intervention rates between e-prescribing, 11.7%, and handwritten, 15.4%, prescriptions, the study authors note.

E-prescribing appears to be good for patients, however. Surescripts underscores that e-prescribing is helping to improve “first fill” medication adherence.

U.S. Pharmacist Social Connect