دورية أكاديمية
Effects of an e-Prescribing interface redesign on rates of generic drug prescribing: exploiting default options.
| العنوان: | Effects of an e-Prescribing interface redesign on rates of generic drug prescribing: exploiting default options. |
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| المؤلفون: | Malhotra S; Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA Physician Organization, Weill Cornell Medical College, New York, NY, USA sam2032@med.cornell.edu., Cheriff AD; Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA Physician Organization, Weill Cornell Medical College, New York, NY, USA Department of Medicine, Weill Cornell Medical College, New York, NY, USA., Gossey JT; Physician Organization, Weill Cornell Medical College, New York, NY, USA Department of Medicine, Weill Cornell Medical College, New York, NY, USA., Cole CL; Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA Physician Organization, Weill Cornell Medical College, New York, NY, USA Department of Medicine, Weill Cornell Medical College, New York, NY, USA., Kaushal R; Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA Department of Medicine, Weill Cornell Medical College, New York, NY, USA Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA., Ancker JS; Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA. |
| المصدر: | Journal of the American Medical Informatics Association : JAMIA [J Am Med Inform Assoc] 2016 Sep; Vol. 23 (5), pp. 891-8. Date of Electronic Publication: 2016 Feb 17. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 9430800 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-974X (Electronic) Linking ISSN: 10675027 NLM ISO Abbreviation: J Am Med Inform Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2015- : Oxford : Oxford University Press Original Publication: Philadelphia, PA : Hanley & Belfus, c1993- |
| مواضيع طبية MeSH: | Electronic Prescribing* , Medical Order Entry Systems* , User-Computer Interface*, Drug Substitution/*statistics & numerical data , Drugs, Generic/*therapeutic use , Practice Patterns, Physicians'/*statistics & numerical data, Ambulatory Care ; Drug Utilization Review ; Humans ; Retrospective Studies |
| مستخلص: | Objective: Increasing the use of generic medications could help control medical costs. However, educational interventions have limited impact on prescriber behavior, and e-prescribing alerts are associated with high override rates and alert fatigue. Our objective was to evaluate the effect of a less intrusive intervention, a redesign of an e-prescribing interface that provides default options intended to "nudge" prescribers towards prescribing generic drugs. Methods: This retrospective cohort study in an academic ambulatory multispecialty practice assessed the effects of customizing an e-prescribing interface to substitute generic equivalents for brand-name medications during order entry and allow a one-click override to order the brand-name medication. Results: Among drugs with generic equivalents, the proportion of generic drugs prescribed more than doubled after the interface redesign, rising abruptly from 39.7% to 95.9% (a 56.2% increase; 95% confidence interval, 56.0-56.4%; P < .001). Before the redesign, generic drug prescribing rates varied by therapeutic class, with rates as low as 8.6% for genitourinary products and 15.7% for neuromuscular drugs. After the redesign, generic drug prescribing rates for all but four therapeutic classes were above 90%: endocrine drugs, neuromuscular drugs, nutritional products, and miscellaneous products. Discussion: Changing the default option in an e-prescribing interface in an ambulatory care setting was followed by large and sustained increases in the proportion of generic drugs prescribed at the practice. Conclusions: Default options in health information technology exert a powerful effect on user behavior, an effect that can be leveraged to optimize decision making. (© The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.) |
| فهرسة مساهمة: | Keywords: Drug substitution; electronic health records; electronic prescribing; generic drugs; human-computer interaction; order entry systems |
| المشرفين على المادة: | 0 (Drugs, Generic) |
| تواريخ الأحداث: | Date Created: 20160226 Date Completed: 20171128 Latest Revision: 20180827 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1093/jamia/ocv192 |
| PMID: | 26911828 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1527-974X |
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| DOI: | 10.1093/jamia/ocv192 |