JAMA study finds more patients obtain medications when they are prescribed electronically

October 26, 2016

A recent study analyzed possible reasons why some patients do not fill prescriptions for dermatologic medications. Notably, researchers found that patients are more likely to obtain medications if they are prescribed in an electronic, rather than paper, format.

80 percent of patients with electronic prescriptions filled all their prescribed medications, while only 63 percent of patients with paper prescriptions did the same.

Elizabeth Suarez

Elizabeth Suarez

Elizabeth A. Suarez, MPH, doctoral student of epidemiology at the UNC Gillings School of Global Public Health, is a co-author of this study. She worked with lead author Adewole D. Adamson, MD, MPP, clinical research instructor in the Department of Dermatology in UNC’s School of Medicine, to explore prescription underuse, which is associated with poorer clinical outcomes for patients.

The full article on their findings, titled “Association Between Method of Prescribing and Primary Nonadherence to Dermatologic Medication in an Urban Hospital Population, ” was published online Oct. 26 by JAMA Dermatology with an accompanying author audio interview.

The researchers analyzed 4,318 prescriptions written for a cohort of 2,496 new patients at one urban hospital’s outpatient dermatology clinic over a period of three years. Their review indicated that, overall, 31.6 percent of patients did not fill all their prescriptions, with the nonadherence rate rising with the number of medications prescribed to a single patient.

In addition to the total number of prescriptions, other identified factors that decreased the likelihood of adherence were age (with nonadherence being highest in patients under 30 or over 70 years old), language (with native English speakers being most likely not to obtain prescriptions) and race/ethnicity (with white and African-American patients being less likely to fill prescriptions than Hispanic patients).

Dr. Adewole Adamson

Dr. Adewole Adamson

Sex and relationship status were not associated with a difference in prescription adherence rates.

Overall, slightly more than one-third of patients in the study did not fill all prescribed medications within one year. Electronic prescriptions, however, resulted in a clear increase in patients who filled all prescriptions.

As medication nonadherence is a common and pervasive public health problem, it should help providers to know that electronic prescribing – in addition to creating more coordinated, accurate health records – is linked with improved rates of patients obtaining prescriptions.

“I think the results are interesting for two reasons,” co-author Suarez said. “First, the failure to fill new prescriptions in dermatology is an understudied area, and we see that a significant percentage of this study population did not obtain all their prescribed medications. Second, having an electronic prescription noticeably improved the likelihood that patients would fill all their new medications. It’s encouraging to see that electronic prescribing could potentially benefit patient outcomes, at least in dermatology patients. This is a new research area for me, and it’s been a great opportunity to explore how patients interact with the health-care system.”


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Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu

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