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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (2)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Electronic Health Records (EHRs) (2)
- (-) Electronic Prescribing (E-Prescribing) (9)
- Healthcare Costs (1)
- Health Information Technology (HIT) (9)
- Medical Errors (3)
- Medication (8)
- Medication: Safety (3)
- Patient Adherence/Compliance (2)
- Patient Safety (4)
- Provider (1)
- Provider: Clinician (1)
- Provider: Pharmacist (1)
- Risk (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 9 of 9 Research Studies DisplayedPitts SI, Yang Y, Thomas B
Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.
This study aimed to describe the proportion of discontinued outpatient medications that would result in a prescription discontinuation, or CancelRx message to understand its impact on medication safety. The authors used a data report to identify all outpatient medications discontinued in the electronic health record (EHR) of an academic health system in 1 month (October 2018). A total of 63,485 medications were discontinued, with 36.4% e-prescribed, 40.9% patient-reported or reconciled, and the remainder prescribed nonelectronically. Discontinued high-risk medications were more likely to be e-prescribed (47%). A discontinuation reason was specified in 58.9% of all discontinued medications. Approximately one-third to one-half of discontinued medications were e-prescribed within the same EHR that would result in a CancelRx message to the pharmacy. Extension of this functionality to reconciled medications in the EHR could significantly expand the impact of CancelRx on medication safety.
AHRQ-funded.
Citation: Pitts SI, Yang Y, Thomas B .
Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.
J Am Med Inform Assoc 2022 Nov 14;29(12):2101-04. doi: 10.1093/jamia/ocac181..
Keywords: Medication, Provider: Pharmacist, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Oke I, Badami A, Kosteva KL
Systemic barriers in receiving electronically prescribed glaucoma medications.
The purpose of this cross-sectional study was to quantify glaucoma medication treatment interruptions attributable to electronically prescribed medications and recommend interventions to reduce this barrier. The researchers reviewed Glaucoma medication refill requests received over a 6-week interval, and then contacted patient pharmacies 1 month after the request date to determine whether the medication was picked up by the patient. Patients who did not pick up the prescriptions were contacted and consented to participate in a survey to identify the barriers to getting the medications. The study found that a prior authorization requirement was significantly associated with patients not obtaining their medication, as well as insurance coverage (32.2%) and availability of the medication at the pharmacy (22.6%). The study concluded that due to the need for prior authorization, insurance coverage, and pharmacy availability, approximately one third of electronically prescribed glaucoma medications were not picked up by patients within one month of the refill request.
AHRQ-funded; HS000063.
Citation: Oke I, Badami A, Kosteva KL .
Systemic barriers in receiving electronically prescribed glaucoma medications.
J Glaucoma 2022 Oct;31(10):812-15. doi: 10.1097/ijg.0000000000002100..
Keywords: Medication, Patient Adherence/Compliance, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Kandaswamy S, Grimes J, Hoffman D
Free-text computerized provider order entry orders used as workaround for communicating medication information.
The objectives of this study are to identify the most common medication names communicated in free-text CPOE orders and their risk levels, to identify what actions physicians expect that nurses will complete when they place free-text CPOE orders, and to describe differences in these patterns across hospitals. Findings showed that the prevalence of medication information in free-text CPOE orders may suggest specific communication challenges in respect to urgency, uncertainty, planning, and other aspects of communication and clinical needs. Recommendations included understanding and addressing communication challenges around commonly mentioned medication names and actions, especially those that are high risk, in order to help reduce the risk of medication errors.
AHRQ-funded; HS025136; HS024755.
Citation: Kandaswamy S, Grimes J, Hoffman D .
Free-text computerized provider order entry orders used as workaround for communicating medication information.
J Patient Saf 2022 Aug 1;18(5):430-34. doi: 10.1097/pts.0000000000000948..
Keywords: Electronic Prescribing (E-Prescribing), Medication, Health Information Technology (HIT)
Iqbal AR, Parau CA, Kazi S
Identifying electronic medication administration record (eMAR) usability issues from patient safety event reports.
This study investigated the contribution of usability challenges associated with the electronic medication administration record (eMAR) to medication errors using patient safety event reports (PSEs). The authors analyzed free-text descriptions of 849 medication-related PSEs selected from 2.3 million reports. Specific health IT components, usability challenge categories, and nuanced usability themes that contributed to each PSE were identified by coders. Usability challenges included workflow support, alerting, and display/visual clutter.
AHRQ-funded; HS025136.
Citation: Iqbal AR, Parau CA, Kazi S .
Identifying electronic medication administration record (eMAR) usability issues from patient safety event reports.
Jt Comm J Qual Patient Saf 2021 Dec;47(12):793-801. doi: 10.1016/j.jcjq.2021.09.004..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Medication, Medical Errors, Patient Safety
King CR, Abraham J, Fritz BA
Predicting self-intercepted medication ordering errors using machine learning.
Current approaches to understanding medication ordering errors rely on relatively small manually captured error samples. These approaches are resource-intensive, do not scale for computerized provider order entry (CPOE) systems, and are likely to miss important risk factors associated with medication ordering errors. Previously, the investigators described a dataset of CPOE-based medication voiding accompanied by univariable and multivariable regression analyses. In this paper, they updated the analysis using machine learning (ML) models to predict erroneous medication orders and identify its contributing factors.
AHRQ-funded; HS025443.
Citation: King CR, Abraham J, Fritz BA .
Predicting self-intercepted medication ordering errors using machine learning.
PLoS One 2021 Jul 14;16(7):e0254358. doi: 10.1371/journal.pone.0254358..
Keywords: Medication, Medical Errors, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Patient Safety, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Kandaswamy S, Pruitt Z, Kazi S
Clinician perceptions on the use of free-text communication orders.
The aim of this study was to investigate (1) why ordering clinicians use free-text orders to communicate medication information; (2) what risks physicians and nurses perceive when free-text orders are used for communicating medication information; and (3) how electronic health records (EHRs) could be improved to encourage the safe communication of medication information. The investigators concluded that clinicians' use of free-text orders as a workaround to insufficient structured order entry can create unintended patient safety risks.
AHRQ-funded; HS025136; HS024755.
Citation: Kandaswamy S, Pruitt Z, Kazi S .
Clinician perceptions on the use of free-text communication orders.
Appl Clin Inform 2021 May;12(3):484-94. doi: 10.1055/s-0041-1731002..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Electronic Health Records (EHRs), Medication: Safety, Medication, Patient Safety, Communication, Provider: Clinician, Provider, Risk
Abraham J, Galanter WL, Touchette D
Risk factors associated with medication ordering errors.
This study’s goal was to collect data on “voided” orders in computerized order entry systems for medication to 1) identify the nature and characteristics of medication ordering errors; 2) investigate the risk factors associated with these errors and; 3) explore potential strategies to mitigate these risk factors. Data was collected using clinician interviews and surveys within 24 hours of the voided order and using chart reviews. During the 16-month study period 1074 medication orders were voided, with 842 being true medication errors. A total of 22% reached the patient, with at least a single administration, but without causing patient harm. Interviews were conducted on 355 voided orders (33%). Errors were associated with multiple factors not just a single risk factor. The causal contributors included a combination of technological-, cognitive-, environment-, social-, and organization-level factors.
AHRQ-funded; HS025443.
Citation: Abraham J, Galanter WL, Touchette D .
Risk factors associated with medication ordering errors.
J Am Med Inform Assoc 2021 Jan 15;28(1):86-94. doi: 10.1093/jamia/ocaa264..
Keywords: Medication: Safety, Electronic Prescribing (E-Prescribing), Medication: Safety, Medication, Medical Errors, Adverse Drug Events (ADE), Adverse Events, Risk, Health Information Technology (HIT), Patient Safety
Joseph S, Sow M, Furukawa MF
AHRQ Author: Furukawa MF
HITECH spurs EHR vendor competition and innovation, resulting in increased adoption.
This study examined the impact of the Health Information Technology for Economic and Clinical Health Act (HITECH). It found increased provider adoption and also provides the first evidence of increased competitiveness and innovation in the electronic health records industry spurred by HITECH.
AHRQ-authored
Citation: Joseph S, Sow M, Furukawa MF .
HITECH spurs EHR vendor competition and innovation, resulting in increased adoption.
Am J Manag Care. 2014 Sep;20(9):734-40..
Keywords: Health Information Technology (HIT), Healthcare Costs, Electronic Prescribing (E-Prescribing), Electronic Health Records (EHRs)
Pevnick JM, Li N, Asch SM
Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.
The researchers evaluated whether formulary decision support (FDS) could reduce patient medication costs, and thereby improve adherence. In the studied population, interruptive FDS shifted prescribing toward preferred tier medications, but these medications were only minimally less expensive for patients. Thus, FDS did not significantly increase adherence.
AHRQ-funded; HS016391.
Citation: Pevnick JM, Li N, Asch SM .
Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.
BMC Med Inform Decis Mak 2014;14:79. doi: 10.1186/1472-6947-14-79..
Keywords: Electronic Prescribing (E-Prescribing), Medication, Patient Adherence/Compliance, Clinical Decision Support (CDS), Health Information Technology (HIT)