title: Meaningful use stage 2 e-prescribing threshold and adverse drug events in the Medicare Part D population with diabetes.
abstract: Evidence supports the potential for e-prescribing to reduce the incidence of adverse drug events (ADEs) in hospital-based studies, but studies in the ambulatory setting have not used occurrence of ADE as their outcome. Using the "prescription origin code" in 2011 Medicare Part D prescription drug events files, the authors investigate whether physicians who meet the meaningful use stage 2 threshold for e-prescribing (≥50% of prescriptions e-prescribed) have lower rates of ADEs among their diabetic patients. Risk of any patient with diabetes in the provider's panel having an ADE from anti-diabetic medications was modeled adjusted for prescriber and patient panel characteristics. Physician e-prescribing to Medicare beneficiaries was associated with reduced risk of ADEs among their diabetes patients (Odds Ratio: 0.95; 95% CI, 0.94-0.96), as were several prescriber and panel characteristics. However, these physicians treated fewer patients from disadvantaged populations.
authors.affiliation: Centers for Medicare and Medicaid Services, Office of Enterprise Data and Analytics, 7500 Security Boulevard, Mailstop B2-29-04, Baltimore, MD julie.bynum@dartmouth.edu.
authors.forename: Christopher
authors.initials: C
authors.lastname: Powers
authors.affiliation: Office of the National Coordinator for Health Information Technology, 200 Independence Avenue SW Suite 745H.2.5, Washington, DC 20201.
authors.forename: Meghan Hufstader
authors.initials: MH
authors.lastname: Gabriel
authors.affiliation: Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850.
authors.forename: William
authors.initials: W
authors.lastname: Encinosa
authors.affiliation: Aledade, 7315 Wisconsin Ave Suite 423W, Bethesda, MD 20814.
authors.forename: Farzad
authors.initials: F
authors.lastname: Mostashari
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, 35 Centerra Parkway, Lebanon, NH 03766.
authors.forename: Julie
authors.initials: J
authors.lastname: Bynum
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D055695:Electronic Prescribing; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D062527:Meaningful Use; D054524:Medicare Part D; D008875:Middle Aged; D014481:United States
keywords: Medicare Part D; adverse drug events; electronic prescribing