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Tracking medication adherence easier in integrated health systems with EHRs, Kaiser Permanente study finds

Electronic health records, integrated systems allow identification of patients not filling new prescriptions

DENVER — Patients using an integrated healthcare system that uses its own pharmacy and electronic health records get their medications filled at a higher rate than those in nonintegrated systems, according to a new study published in the Journal of General Internal Medicine.

The study — conducted by Kaiser Permanente Colorado among 12,061 patients with newly ordered medications for diabetes, blood pressure and cholesterol — found that 93% of patients got their prescriptions for blood pressure drugs filled, along with 89% of those taking diabetes medications and 87% of those taking cholesterol drugs.

Previous studies in nonintegrated health systems found that rates of failure to fill new prescriptions — known as primary nonadherence — were as high as 22%, but the percentage was likely overestimated because those systems must link medication orders and pharmacy claims from different organizations, and pharmacy claims databases don't include patients who don't fill their first prescriptions or those who pay cash, researchers said. By contrast, an integrated health system keeps track of data on who fills a prescription and who doesn't.

"Given that adherence to medications is directly associated with improved clinical outcomes, higher quality of life and lower healthcare costs across many chronic conditions, it is important to examine why some people never start the medications their doctors prescribe," said Marsha Raebel, an investigator in pharmacotherapy with the Kaiser Permanente Colorado Institute for Health Research and the University of Colorado School of Pharmacy. "Having electronic health record medication order entry linked to pharmacy dispensing information makes it easier for clinicians and researchers to identify patients who are not getting their new prescriptions filled."

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