title: Impact of electronic prescribing on medication use in ambulatory care.
abstract: OBJECTIVE
  To investigate differences before and after rollout of electronic prescribing (e-prescribing) in (1) patients' primary adherence to newly prescribed medications, (2) patients' understanding of how to use their medications, and (3) multiple pharmacy use.
  
  
  METHODS
  Postvisit interviews and follow-up phone calls were done with 344 patients at an academic general internal medicine clinic.
  
  
  METHODS
  Patient interviews and follow-up phone calls were done (1) before e-prescribing, (2) 1 to 6 months after e-prescribing, and (3) 12 to 18 months after e-prescribing.
  
  
  RESULTS
  Overall, rates of abandoned prescriptions were 6.9% before e-prescribing, 10.6% 1 to 6 months after e-prescribing, and 2.5% 12 to 18 months after e-prescribing (P = .07). There was a reduction in awareness of the indication for a newly prescribed medicine among patients after e-prescribing (95.4%, 97.9%, and 89.8%, respectively; P = .03). There was a decrease in patients' ability to demonstrate proper use of their new medicine after e-prescribing (69.0% before e-prescribing, 67.1% 1-6 months after e-prescribing, 51.9% 12 -18 months after e-prescribing; P = .02). There was an increasing trend in the percentage of patients using multiple pharmacies after e-prescribing was implemented.
  
  
  CONCLUSIONS
  We found both potential benefits and unexpected consequences as a result of the rollout of electronic prescribing. Adaptation to e-prescribing might be improved with outreach and education, including explicitly informing patients of the change during the first months of rollout. Tangible prescription information for reminder purposes only may also be beneficial.
authors: Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, 750 N Lake Shore Dr, 10th Fl, Chicago, IL 60611. E-mail: a-bergeron@northwestern.edu.
authors: Ashley R
authors: AR
authors: Bergeron
authors: Jennifer R
authors: JR
authors: Webb
authors: Marina
authors: M
authors: Serper
authors: Alex D
authors: AD
authors: Federman
authors: William H
authors: WH
authors: Shrank
authors: Allison L
authors: AL
authors: Russell
authors: Michael S
authors: MS
authors: Wolf
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D055695:Electronic Prescribing; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007087:Illinois; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010594:Pharmacies / Q000706:statistics & numerical data; D011320:Primary Health Care; D016903:Drug Monitoring