228 Comparison of Primary Compliance in Electronic Versus Paper Prescriptions Prescribed From the Emergency Department

Abstract

The Medicare Improvements for Patients and Providers Act passed by Congress in 2008has changed prescribing practices in the United States. Electronic prescriptions (e-prescriptions) have now become the most widely used form of prescriptions. The government in fact financially discourages the use of the older more traditional paper prescriptions.Many emergency medicine physicians fear that this blanket policy is not in the best interests of their unique patient population. It is the belief of many of these physicians that emergency patients are more likely to fill paper prescriptions than e-prescriptions. This theory is predicated on the knowledge that many emergency patients are less established in the system and their visits are frequently rushed, chaotic, and unplanned. For these reasons, the e-prescription system is not ideal for them and the theorized consequence is that many e-prescriptions go unfilled, leaving patients to go untreated.A retrospective analysis was conducted at the emergency department of the University of California, Irvine Medical Center to identify insured adult patients who were given a noncontrolled substance prescription in either the paper or electronic form. Pharmacy claim data to vi insurances was used to determine whether these prescriptions were filled. 405 encounters were included, 218 of which included e-prescriptions and 187 of which included paper prescriptions.Our findings showed that paper prescriptions are filled at the same rate as electronic prescriptions (58.3% versus 57.8% p=1). These results were surprising as they contradicted what many physicians believe is the situation. More studies are needed in order to be able to broaden these results to the entire emergency medicine patient population, but these results may begin to alter prescription practices in emergency medicine.

Effect of Electronic Prescribing Compared to Paper-Based (Handwritten) Prescribing on Primary Medication Adherence in an Outpatient Setting: A Systematic Review

“…39 The full texts of the 15 articles were retrieved and screened using the inclusion and exclusion criteria (second stage of the screening). Five full text articles were then excluded (a short discussion paper, 40 a press release, 41 a master's thesis, 42 one study had no comparator group, 1 and the other study did not use primary medication adherence as an outcome measure 43 ). The final review included the remaining 10 studies.…”