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DENVER — Patients with chronic conditions who get medical care in an integrated health system with electronic health records are much more likely to pick up new prescriptions, according to a study by Kaiser Permanente.
The health care provider said Tuesday that the research, published online in the Journal of General Internal Medicine, found that electronic prescribing makes it easier to identify patients who aren’t getting their prescriptions filled.
The study of 12,061 men and women in Kaiser Permanente Colorado with newly ordered medications for diabetes, blood pressure and cholesterol revealed that only 7% didn’t get their new prescriptions for blood pressure medication filled, 11% failed to pick up new prescriptions for diabetes medication, and 13% didn’t collect new prescriptions for cholesterol-lowering medication.
According to Kaiser Permanente, earlier research of patients in nonintegrated health systems found that primary nonadherence — or when new prescriptions aren’t filled — can be as high as 22%. Yet the health care provider noted that primary nonadherence research in nonintegrated systems probably overestimates the percentage of patients who don’t have their prescriptions filled because medication orders from one organization must be linked with pharmacy claims from a different organization. As a result, pharmacy claims databases don’t include information on patients who never pick up their first prescription and lack information on patients who paid cash for their prescription.
In contrast, in an integrated health system, medication orders can be directly linked to prescriptions filled within the same system, including information on patients who don’t pick up their first prescription.
"Given that adherence to medications is directly associated with improved clinical outcomes, higher quality of life, and lower health care costs across many chronic conditions, it is important to examine why some people never start the medications their doctors prescribe," stated study lead author Marsha Raebel, an investigator in pharmacotherapy with the Kaiser Permanente Colorado Institute for Health Research and with the University of Colorado School of Pharmacy.
"Having electronic health record medication order entry linked to pharmacy dispensing information makes it much easier for clinicians and researchers to identify patients who are not getting their new prescriptions filled," Raebel explained. "The next step is to better understand what the barriers are to people picking up the medications their doctors have prescribed to help them manage diabetes and heart disease."
The study examined pharmacy dispensing records of 12,061 men and women whose average age was 59 during an 18-month period in 2007 and 2008 to see if they picked up newly initiated medications for high blood pressure, diabetes and high cholesterol.
"This group of people has historically been ignored because prescriptions were written on a piece of paper. But now that we have electronic health records with electronic order entry, we can find out patients that did not pick up their first prescription for medications they need," Raebel stated. "Now we need to look at how we can reduce the number of people who do not get their medications."
