Evaluation of electronic prescription implementation in polymedicated users of Catalonia, Spain: a population-based longitudinal study.
OBJECTIVE
To assess whether electronic prescribing is a comprehensive health management tool that may contribute to rational drug use, particularly in polymedicated patients receiving 16 or more medications in the public healthcare system in the Barcelona Health Region (BHR).


METHODS
16 months of retrospective study followed by 12 months of prospective monitoring.


METHODS
Primary healthcare in BHR, Catalonia, Spain.


METHODS
All insured patients, especially those who are polymedicated in six basic health areas (BHA). Polymedicated patients were those with a consumption of ≥16 drugs/month.


METHODS
Monitoring demographic and consumption variables obtained from the records of prescriptions dispensed in pharmacies and charged to the public health system, as well as the resulting drug use indicators. Territorial variables related to implementation of electronic prescribing were also described and were obtained from the institutional data related to the deployment of the project.


METHODS
Trend in drug use indicators (number of prescriptions per polymedicated user, total cost per polymedicated user and total cost per prescription) according to e-prescription implementation.


RESULTS
There was a significant upward trend in the number of polymedicated users, number of prescriptions and total cost (p<0.05), which seemed independent from the implementation of electronic prescribing when comparing the preimplementation and postimplementation period. Prescriptions per user and cost per user showed a decrease between the preimplementation and postimplementation period, being significant in two BHAs (p<0.05).


CONCLUSIONS
Results suggest that after the implementation of electronic prescribing, the rationality of prescribing in polymedicated patients improved. In addition, this study provides a very valuable approach for future impact assessment.
Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain.
Irene
I
Lizano-Díez
Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain.
Pilar
P
Modamio
Department of Pharmaceutical Care and Complementary Benefits, Catalan Health Service, Government of Catalonia, Barcelona, Spain.
Pilar
P
López-Calahorra
Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain.
Cecilia F
CF
Lastra
Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain.
Jose L
JL
Segú
Department of Pharmaceutical Care and Complementary Benefits, Catalan Health Service, Government of Catalonia, Barcelona, Spain.
Antoni
A
Gilabert-Perramon
Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain.
Eduardo L
EL
Mariño
D055695:Electronic Prescribing / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D019338:Polypharmacy; D011446:Prospective Studies; D012107:Research Design; D012189:Retrospective Studies; D013030:Spain
EPIDEMIOLOGY; PRIMARY CARE