Notes on academic paper: Adoption of and experience with e-prescribing by primary care physicians

E-prescribing has been purported to benefit the pharmacy profession in many ways (eg, improved patient medication safety, increased satisfaction with the pharmacy and reduced wait times at the pharmacy).

Respondents also indicated the inability to prescribe controlled substances electronically as problematic. Although the Drug Enforcement Agency (DEA) legalized e-prescribing of controlled substances in June 2010 (after this study was conducted), not all pharmacies or vendors meet the DEA’s requirements to accept or transmit electronic prescriptions from prescribers, and some state boards of pharmacy may place restrictions on controlled substance e-prescribing. Ongoing development of compliant software by pharmacy chains and vendors is vital for facilitating e-prescribing of controlled substances.

A recent study reported no statistically significant differences between the number of unclaimed prescriptions among patients who received standard written prescriptions and patients whose prescriptions were submitted electronically. Patient-reported reasons for not claiming e-prescriptions include perceiving their prescription as unnecessary or not needing their prescription, medication affordability, lack of time, not realizing the medication is at the pharmacy, and no physical evidence of an e-prescription. Prescription fill status notifications are mandated for e-prescribing systems and may help to minimize unclaimed prescriptions if used and acted on by prescribers. However, the fill status notifications still do not guarantee that patients picked up their filled prescriptions.

There have been anecdotal reports from patients that the e-prescription was not at the pharmacy when picking up their prescription.

One of the most salient benefits of e-prescribing is the reduction of preventable medication errors by generating a legible prescription checked by e-prescribing software for drug-drug and other interactions; however, e-prescribing does not completely eliminate preventable medication errors. Data entry errors, such as selecting the wrong drug, may occur from a drop-down menu. Although software vendors continually make efforts to prevent such errors, pharmacists should remain vigilant in detecting such errors occurring because of the e-prescribing software, and research should continually focus on medication error rates from the system as e-prescribing becomes more prevalent. Policy initiatives such as requiring diagnosis codes on electronic, if not all prescriptions, may help reduce data entry and subsequent dispensing errors and improve patient safety.

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