Electronic prescribing to incorporate ‘missing link’


Including ‘why’ patients are taking certain drugs enhances adherence, efficiency; causes less errors

Practicing the five “rights” in prescribing safe medication—the right patient, right drug, right dose, right time, and right route—researchers from Boston, Massachusetts added a sixth element that includes why the drug is advised. This will guide the physician and their patients.

“Currently, even though there is a widespread commitment to sharing drug information with patients, the reason for a medication prescription is generally not recorded or shared when it is being written and is therefore missing a key piece of information,” said Dr. Gordon D. Schiff lead author and general internist at Brigham and Women’s Hospital.

Including the reason of medication on prescription enhances the safety by specifying the medication choices for a particular disease or condition.

This will minimize the errors and mismatches in prescribing or dispensing drugs of similar names. It lets patients understand the necessity of their medication regimens. This also provides clinicians a system to identify therapeutic options that will have the optimum benefits to the patient.

Through this, caregivers, patients, prescribers, and pharmacists are aware on what is being treated and the outcomes of the drug that will achieve. Doctors are able to have clearer assessment to evaluate the prescriptions and calculate the longevity of the drug’s efficacy.

In a Perspective article issue of the New England Journal of Medicine, authors cited an 1833 article from Boston Medical and Surgical Journal that illustrated how patients were purposely kept in the dark about the ingredients and indications for their drugs so that they could rely heavily on the skill of the doctor.

Moreover, this explains why prescriptions were written in Latin to prevent patients from learning the names of the medications.

With support from the U.S. Agency for Healthcare Research and Quality (AHRQ), researchers are working with information technology design specialists and policy leaders for a three-year project to build a prototype that allows prescribers to start from the patient’s problem and direct the users toward the best options.

“We will be testing our hypothesis that electronic prescribing needs to incorporate this missing link and that this system will result in a safer, more efficient way of ordering medications to benefit patients, families, prescribers, pharmacists, and other members of the health care team,” Schiff concluded. Ma. Vanessa L. Estinozo with NEJM report

Vital Signs August 2016