aportes a la gestión necesaria para la sustentabilidad de la SALUD PÚBLICA como figura esencial de los servicios sociales básicos para la sociedad humana, para la familia y para la persona como individuo que participa de la vida ciudadana.
miércoles, 8 de marzo de 2017
E-Prescribing and Adverse Drug Events: An Observational Study of the Medicare Part D Population With Diabetes. - PubMed - NCBI
Electronic prescribing (e-prescribing), which is intended to ensure that accurate, error-free and understandable prescriptions are sent directly to pharmacies, was found to lower the risks among diabetes patients of experiencing adverse drug events that required emergency department visits or hospitalizations. In an AHRQ-supported article, researchers examined 2011–2013 data for 3.1 million Medicare Part D beneficiaries who were 66 or older and had taken antidiabetes medications for at least 90 days. Their analysis, published in Medical Care, showed 21 adverse drug events per 1,000 beneficiaries who had at least 75 percent of their medications e-prescribed. Beneficiaries with less e-prescribing, meanwhile, had more adverse drug events—with the highest rate, 44 events per 1,000 diabetes patients, occurring for those patients who had 0.1 percent to 24.9 percent of their prescriptions handled electronically. Access the abstract.
Although the adoption of e-prescriptions among physicians has increased substantially under the Medicare Improvements for Patients and Providers Act and Meaningful Use programs, little is known of its impact on patient outcomes.
To examine the impact of e-prescribing on emergency visits or hospitalizations for diabetes-related adverse drug events (ADEs) including hypoglycemia.
This is a prospective, observational cohort study with patient fixed effects.
2011-2013 fee for service Medicare.
In total, 3.1 million Medicare fee for service, Part D enrolled beneficiaries over age 66 with diabetes mellitus and at least 90 days of antidiabetic medications.
E-prescribing was measured as the percentage of all prescriptions a person received transmitted to the pharmacy electronically. The outcome measure was the occurrence of an emergency department (ED) visit or hospitalization for hypoglycemia or diabetes-related ADE.
Unadjusted results show that there were 21 ADEs per 1000 beneficiaries that had ≥75% of their medications e-prescribed. Beneficiaries with lower e-prescribing levels had significantly higher numbers of ADEs. We found a robust association between the greater use of electronic prescriptions in the outpatient setting and the lower risk of an inpatient or ED visit for an ADE event among Medicare beneficiaries with diabetes in our adjusted analysis. At the e-prescribing threshold of 75% and above, significant reductions in ADE risk can be seen.
As an observational study, the results show an association but do not prove causation.
Use of e-prescribing is associated with lower risk of an ED visit or hospitalization for diabetes-related ADE.
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