Appl Clin Inform 2021; 12(04): 845-855
DOI: 10.1055/s-0041-1735182
Review Article

Effect of Electronic Prescribing Compared to Paper-Based (Handwritten) Prescribing on Primary Medication Adherence in an Outpatient Setting: A Systematic Review

David Aluga
1   School of Health and Life Sciences, Teesside University Middlesbrough, Middlesbrough, United Kingdom
,
Lawrence A. Nnyanzi
1   School of Health and Life Sciences, Teesside University Middlesbrough, Middlesbrough, United Kingdom
,
Nicola King
2   Student and Library Services, Teesside University Middlesbrough, Middlesbrough, United Kingdom
,
Elvis A. Okolie
1   School of Health and Life Sciences, Teesside University Middlesbrough, Middlesbrough, United Kingdom
,
Peter Raby
1   School of Health and Life Sciences, Teesside University Middlesbrough, Middlesbrough, United Kingdom
› Author Affiliations

Abstract

Background Electronic prescriptions are often created and delivered electronically to the pharmacy while paper-based/handwritten prescriptions may be delivered to the pharmacy by the patients. These differences in the mode of creation and transmission of the two types of prescription could influence the rate at which outpatients fill new prescriptions of previously untried medications.

Objectives This study aimed to evaluate literatures to determine the impact of electronic prescribing compared with paper-based/handwritten prescribing on primary medication adherence in an outpatient setting.

Methods The keywords and phrases “outpatients,” “e-prescriptions,” “paper-based prescriptions,” and “primary medication adherence” were combined with their relevant synonyms and medical subject headings. A comprehensive literature search was conducted on EMBASE, CINAHL, and MEDLINE databases, and Google Scholar. The results of the search were screened and selected using predefined inclusion and exclusion criteria. The Critical Appraisal Skills Program (CASP) was used for quality appraisal of included studies. Data relevant to the objective of the review were extracted and analyzed through narrative synthesis.

Results A total of 10 original studies were included in the final review, including 1 prospective randomized study and 9 observational studies. Nine of the 10 studies were performed in the United States. Four of the studies indicated that electronic prescribing significantly increases initial medication adherence, while four of the studies suggested the opposite. The remaining two studies found no significant difference in primary medication adherence between the two methods of prescribing. The variations in the studies did not allow the homogeneity required for meta-analysis to be achieved.

Conclusion The conflicting findings relating to the efficacy of primary medication adherence across both systems demonstrate the need for a standardized measure of medication adherence. This would help further determine the respective benefits of both approaches. Future research should also be conducted in different countries to give a more accurate representation of adherence.

Protection of Human and Animal Subjects

This is a secondary study that synthesized the findings of original studies. No human or animal subjects were recruited.


Supplementary Material



Publication History

Received: 16 March 2021

Accepted: 15 July 2021

Article published online:
25 August 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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