Researchers at Weill Cornell Medical College credit e-prescribing with a seven-fold reduction in medication error in a new study published in the online edition of the Journal of General Internal Medicine. In the United States there is a strong national push to encourage doctors to adopt e-prescribing. An estimated 2.6 billion drugs are provided, prescribed, or continued at ambulatory care visits.

 

To assess the effects of e-prescribing on medication errors, the authors looked at the number and severity of prescribing errors–such as ordering a medication but omitting the quantity, prescribing a drug to a patient with a known allergy to the active ingredient and injuries from medication–in 12 community-based medical practices in the Hudson Valley region of New York.

 

The researchers compared the number of prescription errors between those who adopted e-prescribing (15 doctors) and those who stuck with paper-based prescriptions (15 doctors) between September 2005 and June 2007. In total, the researchers analyzed 3,684 paper-based prescriptions at the start of the study, and 1,543 paper-based and 2,305 electronic prescriptions after a year.

 

The providers who adopted e-prescribing over the study period used a commercial, stand-alone system with clinical decision support such as dosing recommendations and checks for drug-allergy interactions, drug-to-drug interactions and duplicate therapies.

 

The researchers found that among those who used e-prescribing, there was an almost seven-fold decrease in prescribing errors after one year–from 42.5 percent at the start of the study to 6.6 percent after a year. In contrast, among those who used traditional paper-based prescriptions, the level of errors remained high: 37.3 percent at baseline versus 38.4 percent at one year. Predictably, illegibility errors were completely eliminated by e-prescribing.

 

“Prescribing errors may occur much more frequently in community-based practices than previously reported,” the authors write. “Our study is one of the first to demonstrate a reduction in prescribing errors in ambulatory solo and small group community practices, where e-prescribing adoption and usage has lagged. Our findings suggest that stand-alone e-prescribing with clinical decision support may significantly improve ambulatory medication safety.”