AHRQ Study: Electronic Prescribing Linked to Fewer Adverse Drug Events Among Patients With Diabetes

Physicians who primarily issue prescriptions electronically have lower rates of adverse drug events (ADEs) among their patients with diabetes, according to an AHRQ study in the Journal of the American Medical Informatics Association. The study used 2011 Medicare Part D drug claims data, representing nearly 28 million Medicare beneficiaries, to investigate ADE rates of physicians who used e-prescribing for 50 percent or more of prescriptions (and therefore met the CMS meaningful use stage 2 threshold for e-prescribing). Those physicians were compared with physicians who prescribed primarily in writing, by telephone or in other ways. Of nearly 130,000 physicians included in the study, 25 percent were considered high e-prescribers because they met the meaningful use threshold in 2011. Five percent of high e-prescribers had at least one patient with an ADE, compared with 6.5 percent of low e-prescribers. High e-prescribing was associated with a reduced risk of hospital or emergency department visits for hypoglycemia or ADEs related to anti-diabetes medications. The study, “Meaningful Use Stage 2 E-Prescribing Threshold and Adverse Drug Events in the Medicare Part D Population With Diabetes,” and abstract were published May 6. Co-authors included AHRQ’s William Encinosa, Ph.D.

2015 Sep;22(5):1094-8. doi: 10.1093/jamia/ocv036. Epub 2015 May 6.

Meaningful use stage 2 e-prescribing threshold and adverse drug events in the Medicare Part D population with diabetes.

Powers C1, Gabriel MH2, Encinosa W3, Mostashari F4, Bynum J5.

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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.