Physicians: Use EHRs to notify pharmacies of discontinued prescriptions

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Electronic health records can reduce the dispensing of discontinued medications, which can cause patient harm, according to a study published Nov. 20 in the Annals of Internal Medicine.

The study's authors, according to an article in MedPage Today, noted that while physicians were using their EHRs to electronically transmit prescriptions to pharmacies for dispensing, they didn't routinely communicate medication discontinuation orders, which caused some medications to be refilled unnecessarily.

The study, conducted at a large multi-specialty group practice with 15 ambulatory health centers in Eastern Mass., reviewed 30,406 adult patients with electronic discontinued orders for various medications, such as statins, anticoagulants and antihypertensive drugs.

The researchers found that dispensing of discontinued medications does occur and results in potential harm in many cases. Of the 83,902 targeted medications that had been electronically discontinued, 1,218 (1.5 percent) still were refilled by the pharmacy within 12 months of the discontinuation. Of these dispensed drugs, more than one-third (34 percent) met the criteria for higher risk of potential adverse effects; potential harm was identified 12 percent of the time, due to duplicated dispensing, lab abnormalities and drug allergy issues.

"Electronic health records offer a clear opportunity to track when a clinician discontinues a medication, and these discontinuation orders should be transmitted electronically to the retail pharmacy," the study's authors said. "Even more broadly, electronic health records should be used to facilitate ongoing bidirectional communication between physician offices and retail pharmacies, ensuring that new prescription orders are transmitted, current medications are verified, and discontinued medications are removed from the pharmacy list."

The researchers also recommended that patient awareness of their medication lists be increased so that they can more readily identify incorrect dispensing.

Other studies have found that EHRs can facilitate communication among providers and patients to improve patient safety, and that patients are willing to be involved in the review of their records and medication lists.

To learn more:
- here's the study's abstract
- read this MedPage Today article

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