Electronic prescribing allows physicians to monitor their patients medication use in detail, and although this may require more time, a new study of asthma patients finds it can have a significant payoff.
The study was conducted by researchers at Henry Ford Hospital in Detroit, who studied the use of inhaled corticosteroids (ICS) for asthma control. ICS, taken using an inhaler, help prevent and reduce airway swelling, and are considered the cornerstone therapy for controlling persistent asthma in patients, says lead study author L. Keoki Williams, MD, Center for Health Services Research and Department of Internal Medicine at Henry Ford Hospital.
The study found patients were more likely to routinely take ICS for asthma control when physicians kept close watch over their medication use and reviewed detailed electronic prescription information, including how often patients fill their prescriptions and the estimated number of days each prescription would last.
The Henry Ford scientific team set out to design an intervention that would provide physicians information on the most recent national asthma guidelines and methods for discussing medication non-adherence with their patients. It also offered physicians electronic access to patients' medication prescription fill/refill information via Henry Ford's e-prescribing application, part of its electronic medical record system that allows physicians to prescribe and review patient medications electronically.
The study enrolled 193 Henry Ford primary care physicians (family medicine, internal medicine, pediatrics). Eighty-eight were randomly assigned to the intervention group, while 105 were assigned to the control group (no intervention).
Physicians in the intervention group used e-prescribing to track medication fills and refills, including estimates of the proportion of time that the patients took their medication.
Medication adherence for both groups was measured by using both electronic prescriptions and pharmacy claims for medication fills and refills.
Researchers found ICS adherence to be very similar among patients in the intervention group and those in the control group (21.3 percent vs. 23.3 percent). But they found adherence was significantly higher in the intervention group (35 percent) when the patient's physician elected to view detailed adherence information via the e-prescribing application.
Few physicians in the intervention group, however, accessed the detailed adherence information. "Going forward, one of the obstacles will be finding time for physicians to review and discuss this information with patients in their typically busy practices," says Williams.
The study appears online in the Journal of Allergy and Clinical Immunology.
