Dissertation/Thesis Abstract

The Association Between Electronic Prescriptions and New Prescription Abandonment in the Elderly
by Forestal, Doris Alexandra, Ph.D., University of the Sciences in Philadelphia, 2018, 137; 10904831
Abstract (Summary)

BACKGROUND: Electronic prescriptions have been promoted as a means to decrease medication errors, improve efficiency at the pharmacy and increase medication adherence. Studies disagree on whether electronic prescriptions increase or reduce prescription abandonment. Understanding the impact of electronic prescriptions on new prescription abandonment is important, particularly in a poor elderly population that is prone to comorbidities.

OBJECTIVE: To assess whether electronic prescriptions are associated with new prescription abandonment in the elderly.

METHODS: This was a cross-sectional study using a sample of new prescription claims from the 10 most common drug classes submitted to the Pharmaceutical Assistance Contract for the Elderly (PACE) program in 2015. Rates of prescription abandonment were determined through the chi-square test of independence and binary logistic regression analyses were used to predict prescription abandonment, using claim reversals as proxy measure.

RESULTS: Nine independent variables were statistically significant related to the dependent variable. Key findings were that electronic prescriptions were 22.8% more likely to be reversed than prescriptions from other origins. Claims for institutionalized beneficiaries were twice as likely to be reversed than for non-institutionalized patients. Claims with out of pocket (OOP) costs <$9 and $9-15.99 were less likely to be abandoned than claims with OOP costs ≥ $16. These results must be considered with caution considering the poor model fit in the logistic regression analyses, perhaps resulting from skewed data and presenting inherent limitations.

CONCLUSION: The results of this study indicate that electronic prescriptions may be associated with new prescription abandonment in the elderly. Moreover, these findings suggest that certain factors, such as out of pocket costs and patient location magnified this effect. Electronic prescription abandonment is concerning, given increased utilization of e-prescribing in the past decade. This study offers new insight, particularly as it focused on a poor elderly population that may be prone to polypharmacy and may not easily cope with the financial burden of drugs. This study aspires to support policy decisions aiming to reduce new prescription abandonment, but more research is needed to discern causes of abandonment of electronic prescriptions in the elderly.

Indexing (document details)
Advisor:
Commitee:
School: University of the Sciences in Philadelphia
Department: Health Policy and Public Health
School Location: United States -- Pennsylvania
Source: DAI-B 79/12(E), Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Public health, Health care management
Keywords: E-prescribing, Elderly, Electronic prescriptions, Pace, Prescription abandonment
Publication Number: 10904831
ISBN: 9780438157354
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