Evaluation of electronic prescription implementation in polymedicated users of Catalonia, Spain: a population-based longitudinal study

PurposeCurrent COPD management recommendations indicate that pharmacological treatment can be stepped up or down, but there are no recommendations on how to make this adjustment. We aimed to describe pharmacological prescriptions during a routine clinical visit for COPD and study the determinants of changing therapy.MethodsEPOCONSUL is a Spanish nationwide observational cross-sectional clinical audit with prospective case recruitment including 4,508 COPD patients from outpatient respiratory clinics for a period of 12 months (May 2014–May 2015). Prescription patterns were examined in 4,448 cases and changes analyzed in stepwise backward, binomial, multivariate, logistic regression models.ResultsPatterns of prescription of inhaled therapy groups were no treatment prescribed, 124 (2.8%) cases; one or two long-acting bronchodilators (LABDs) alone, 1,502 (34.6%) cases; LABD with inhaled corticosteroids (ICSs), 389 (8.6%) cases; and triple therapy cases, 2,428 (53.9%) cases. Incorrect prescriptions of inhaled therapies were observed in 261 (5.9%) cases. After the clinical visit was audited, 3,494 (77.5%) cases did not modify their therapeutic prescription, 307 (6.8%) cases had a step up, 238 (5.3%) cases had a change for a similar scheme, 182 (4.1%) cases had a step down, and 227 (5.1%) cases had other nonspecified change. Stepping-up strategies were associated with clinical presentation (chronic bronchitis, asthma-like symptoms, and exacerbations), a positive bronchodilator test, and specific inhaled medication groups. Stepping down was associated with lung function impairment, ICS containing regimens, and nonexacerbator phenotype.ConclusionThe EPOCONSUL study shows a comprehensive evaluation of pharmacological treatments in COPD care, highlighting strengths and weaknesses, to help us understand how physicians use available drugs.

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“…Fortunately, the implementation of electronic prescription in Spain will probably help clinicians to correct all these prescriptions. 32 …”

Section: Discussionmentioning

confidence: 99%

Determinants of medical prescriptions for COPD care: an analysis of the EPOCONSUL clinical audit

Lόpez-Campos

Alcázar²,

Soriano

et al. 2018

COPD

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“…GPs are also increasingly seeking out eHealth services, such as digital prescribing and email consultations, to improve patients’ access to health care, patients’ quality of care, and service efficiency [ 2 , 25 ]. For example, a recent study of electronic prescribing suggests that after the implementation, the appropriate prescribing in polymedicated patients improved [ 26 ]. This is in line with our findings that GPs are optimistic about the potential of eHealth to increase access to primary care and improve quality of care.…”

Section: Discussionmentioning

confidence: 99%

Use and Uptake of eHealth in General Practice: A Cross-Sectional Survey and Focus Group Study Among Health Care Users and General Practitioners

Peeters¹,

Krijgsman²,

Brabers³

et al. 2016

JMIR Med Inform

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BackgroundPolicy makers promote the use of eHealth to widen access to health care services and to improve the quality and safety of care. Nevertheless, the enthusiasm among policy makers for eHealth does not match its uptake and use. eHealth is defined in this study as “health services delivered or enhanced through the Internet and related information and communication technologies.”ObjectiveThe objective of this study was to investigate (1) the current use of eHealth in the Netherlands by general practitioners (GPs) and health care users, (2) the future plans of GPs to provide eHealth and the willingness of health care users to use eHealth services, and (3) the perceived positive effects and barriers from the perspective of GPs and health care users.MethodsA cross-sectional survey of a sample of Dutch GPs and members of the Dutch Health Care Consumer Panel was conducted in April 2014. A pre-structured questionnaire was completed by 171 GPs (12% response) and by 754 health care users (50% response). In addition, two focus groups were conducted in June 2014: one group with GPs (8 participants) and one with health care users (10 participants).ResultsThree-quarters of Dutch GPs that responded to the questionnaire (67.3%, 115/171) offered patients the possibility of requesting a prescription via the Internet, and half of them offered patients the possibility of asking a question via the Internet (49.1%, 84/171). In general, they did intend to provide future eHealth services. Nonetheless, many of the GPs perceived barriers, especially concerning its innovation (eg, insufficient reliable, secure systems) and the sociopolitical context (eg, lack of financial compensation for the time spent on implementation). By contrast, health care users were generally not aware of existing eHealth services offered by their GPs. Nevertheless, half of them were willing to use eHealth services when offered by their GP. In general, health care users have positive attitudes regarding eHealth. One in five (20.6%, 148/718) health care users perceived barriers to the use of eHealth. These included concerns about the safety of health information obtained via the Internet (66.7%, 96/144) and privacy aspects (55.6%, 80/144).ConclusionsGPs and health care users have generally positive attitudes towards eHealth, which is a prerequisite for the uptake of eHealth. But, general practitioners in particular perceive barriers to using eHealth and consider the implementation of eHealth to be complex. This study shows that there is room for improving awareness of eHealth services in primary care. It will take some time before these issues are resolved and eHealth can be fully adopted.

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“…Electronic prescription is being tested, implemented, or is still implemented according to the domestic needs in several countries [8]. Implementing the e-prescribing system leads to addressing the entire process involving the pharmaceutical services as it is a comprehensive health management tool [9].…”

Section: Introductionmentioning

confidence: 99%

Perceived Utilization of E-Prescription During Covid-19 Pandemic in Communities of Davao City

Perales,

Hernandez,

Braga

et al. 2023

Int. J. Res. Publ. Rev.

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The occurrence of pandemic led to health services shifting and implementing a new method of giving service and that is Electronic Prescribing. Electronic prescribing (e-prescribing) was one of the innovations which were introduced in order for healthcare professionals and patients to lessen their interactions in dispensing medicines. In the Philippines, the government has issued Community Quarantine, and the Food and Drug Administration has seen a need to implement and adopt an alternative means of using electronic prescription for drugs for the benefit of individuals vulnerable to COVID-19. In Davao City, telephone medicine is being utilized to accept prescriptions, whether in the form of text messages or sent via email. The respondents of this study are the residents of Davao City, Philippines, ranging from ages 18-59 years old. People who reside outside Davao City are excluded from the study and those residents of Davao City who have utilized an e-prescription are included in the study. Only the main urban center of the said city is included. The mentioned main urban centers in the Davao City Infrastructure Development Plan and Capacity Building Project are the districts of Poblacion, Agdao, Buhangin, and Talomo. The overall findings showed that the majority of respondents were between the ages of 18-35 years old, female and are high school graduates. Results also showed that respondents who utilize recorded images as the format for electronic prescriptions. During the period of the pandemic, the majority of the respondents also used e-prescription anywhere from one to three times, most of them used e-prescription to relieve symptoms of illnesses and the majority of them used e-prescription to purchase antibiotics.The researchers were able to evaluate and analyze the perceived utilization to electronic prescriptions among residents of Davao City in the community setting during the COVID-19 pandemic in order to fully implement the use of electronic prescriptions even after the pandemic, as the circular order from the Food and Drug Administration for the use of electronic means of prescription is only implemented until the quarantine is lifted. In conclusion, the use of e-prescription is heavily influenced by cognitive flexibility, technological literacy, convenience, and attitude. Therefore, the null hypothesis is rejected and the alternative hypothesis stating that there is a significant difference between the respondent's demographic profile and the level of perceived utilization to e-prescription among residents of Davao City during the COVID-19 pandemic is accepted.

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Evaluation of electronic prescription implementation in polymedicated users of Catalonia, Spain: a population-based longitudinal study

Cited by 13 publications

References 17 publications

Determinants of medical prescriptions for COPD care: an analysis of the EPOCONSUL clinical audit

Determinants of medical prescriptions for COPD care: an analysis of the EPOCONSUL clinical audit

Use and Uptake of eHealth in General Practice: A Cross-Sectional Survey and Focus Group Study Among Health Care Users and General Practitioners

Perceived Utilization of E-Prescription During Covid-19 Pandemic in Communities of Davao City

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