4 ways e-prescribing improves medication adherence

According to the U.S. Centers for Disease Control and Prevention (CDC), 20 percent to 30 percent of prescriptions are never filled. When medications are filled, adherence tends to decline after six months. In fact, about half of medications are not continued as prescribed.

The direct cost of medication nonadherence is estimated at $100 billion to $289 billion annually. It has a direct impact on patient outcomes, causing 30 percent to 50 percent of treatment failures and 125,000 deaths per year, according to the CDC and the World Health Organization (WHO).

Medication adherence is influenced by several social and economic factors as well as patient behavior, but there are steps providers can take to improve adherence to medication regimens and improve patient outcomes. The CDC recommends a strategy it calls SIMPLE:

S – Simplify the regimen

I – Impart knowledge

M – Modify patient beliefs and behavior

P – Provide communication and trust

L – Leave the bias

E – Evaluate adherence

How e-prescribing impacts medication adherence

Electronic prescribing can be part of the process of improving medication adherence. One study found a 10 percent increase in first-fill medication adherence for electronically prescribed medications versus paper, phone and faxed prescriptions (Surescripts, 2012).

Here are 4 ways e-prescribing helps improve patient outcomes and adherence:

  1. Automatic renewals: Prescribing 90-day prescription supplies and ordering automatic renewals can counter patient forgetfulness, the CDC notes.
  2. Aligned with patient preferences: In a study published in Perspectives in Health Information Management, 81 percent of adults over the age of 50 taking multiple prescription medications said they preferred e-prescriptions. Nearly 30 percent said e-prescribing improved their medication adherence.
  3. Improved communication with patients: E-prescribing technology provides instant information about the patient’s drug formulary, which can inform discussions with patients about drug costs and, if necessary, other options. This leads to improved medication adherence.
  4. Lower prescription costs: The higher the copay, the better the chance the prescription won’t be filled. With e-prescribing, doctors have patient insurance and medication history on hand.

Using electronic health records to track medication adherence

E-prescribing also “builds a more complete medication history from all the pharmacies and physicians a patient may use,” according to the Health Resources and Services Administration (HRSA), part of the U.S. Department of Health and Human Services (HHS). “This can then be transmitted back to prescribers to help them evaluate and focus on issues of patient compliance.”

The Centers for Medicare and Medicaid Services (CMS) requires that electronic health records (EHRs) support e-prescribing, drug utilization review and medication reconciliation, notes a January 2014 white paper funded by the Pharmaceutical Research and Manufacturers of America.

They also must be able to download medication history, although the quality of information available varies widely, the paper notes.

Longer term, the Office of the National Coordinator for Health IT (ONC) is advocating for providers to be automatically notified when prescriptions go unfilled. That can “trigger an intervention to avoid gaps in medication usage,” according to the ONC.