EHRs can help improve patient medication adherence

The pharmacy claims data in electronic health records can identify patients who don't fill their prescriptions in real time, enabling prescribing physicians an opportunity to follow up with them promptly to improve medication adherence, according to a new study published in the American Journal of Managed Care.

Lack of medication adherence is a common problem among patients, particularly those with high blood pressure, since the patients are often asymptomatic. The resulting nonadherence is associated with adverse clinical outcomes.   

The researchers, from Delaware's Christiana Care Health System and elsewhere, wanted to see if they could use aggregate pharmacy claims data in EHRs to identify those patients who weren't filling their new blood pressure prescriptions. Using the EHRs of a large multi-specialty practice with 14 primary care sites in Northern Delaware, they identified 791 patients who were previously diagnosed with hypertension and prescribed a new antihypertensive drug between January 2011 and September 2012. Of those patients, 66 percent filled the prescriptions within 30 days, and most of them did so on the day they received the prescription.

Patients who did not fill the prescriptions were more likely to be older, with non-cardiovascular comorbidities and higher medication burdens, and insured by Medicare as opposed to other payers. Interestingly, patients with lower diastolic blood pressure also were more often nonadherent, which the researchers suggested was because those patients didn't see an urgent need to fill the prescription.

"[T]he increased availability of medication fill histories in clinical practice can provide objective insight into a patient's medication adherence, and may provide a foundation for targeted interventions to improve primary nonadherence," the authors concluded. They recommended, among other things, that such information can be used to have the EHR generate a prompt for a follow-up call or letter to patients where there is no evidence of a prescription fill within a certain time period after issuing it.

EHRs have been found to help identify patients at high risk for certain diseases and to improve prescribing for patients. EHRs may continue to help with prescriptions as electronic prescribing continues to grow in popularity.

To learn more:
- read the study