Barriers to electronic prescribing of controlled substance, especially opioids

Amne Borghol; Fahamina Ahmed; Dana Jamero; Helen Calmes; Taylor Monthey; Stefanie Pappas; Rotieranna Scott; Joshua S. Deblieux; Melanie Ulrich; Sonia Malhotra

doi:10.5055/jom.0857

Authors

Amne Borghol, PharmD, BCPS https://orcid.org/0000-0002-0028-7174
Fahamina Ahmed, PharmD
Dana Jamero, PharmD, BCOP
Helen Calmes, PharmD, MBA
Taylor Monthey, PharmD Candidate
Stefanie Pappas, PharmD Candidate
Rotieranna Scott, PharmD Candidate
Joshua S. Deblieux, MD
Melanie Ulrich, MD
Sonia Malhotra, MD, MS, FAAP

DOI:

https://doi.org/10.5055/jom.0857

Keywords:

electronic prescribing, e-prescribing, opioids, preferences, medication safety

Abstract

Objective: Electronic prescriptions are now the standard of practice for all discharge and outpatient prescriptions. The intention is to increase patient safety, provide a more complete medication record for patients, lessen the burden on prescribers, and shorten the time it takes for medication orders to reach the pharmacy.

Design: This cross-sectional questionnaire survey study was conducted between January and August 2022 in three areas of a large urban safety net hospital. Setting: A large single academic medical center.

Participants: Emergency department, inpatient clinicians, and procedural areas. The subjects of the study were trainees, attending physicians, and advance practice providers (APPs)

Interventions: Data were collected from the participants using a self-reported questionnaire, including sociodemographic characteristics, ease of use, reliability, and preference. Additionally, the perception of the strengths and limitations associated with electronic prescribing (e-prescribing) were analyzed.

Main outcome measure: The purpose of this study was to evaluate the barriers to e-prescribing of opioids.

Results: A total of 121 prescribers completed the survey. The majority trusted that e-prescribing were transmitted successfully (62 percent), saved time (78 percent), and did not interrupt their workflow (78 percent). However, many prescribers indicated that additional improvements are needed, such as updating the patient’s preferred pharmacy in the electronic medical record during each visit (52 percent) and having a 24-hour pharmacy readily available (66 percent).

Conclusion: Prescribers value the ease of use of e-prescribing and how time efficient the process can be. Nevertheless, there is a need to improve the system’s service, design, and usefulness.

Author Biographies

Amne Borghol, PharmD, BCPS

Clinical Professor, Division of Clinical and Administrative Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana

Fahamina Ahmed, PharmD

Clinical Associate Professor, Division of Clinical and Administrative Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana

Dana Jamero, PharmD, BCOP

Chair and Clinical Associate Professor, Division of Clinical and Administrative Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana

Helen Calmes, PharmD, MBA

Clinical Pharmacist, University Medical Center of New Orleans, New Orleans, Louisiana

Taylor Monthey, PharmD Candidate

Xavier University of Louisiana, College of Pharmacy, New Orleans, Louisiana

Stefanie Pappas, PharmD Candidate

Xavier University of Louisiana, College of Pharmacy, New Orleans, Louisiana

Rotieranna Scott, PharmD Candidate

Xavier University of Louisiana, College of Pharmacy, New Orleans, Louisiana

Joshua S. Deblieux, MD

PGY-3 Resident Emergency Medicine, Louisiana State University, University Medical Center of New Orleans, New Orleans, Louisiana

Melanie Ulrich, MD

Emergency Medicine and Hospice & Palliative Medicine, Louisiana State University, University Medical Center of New Orleans, New Orleans, Louisiana

Sonia Malhotra, MD, MS, FAAP

Associate Professor of Internal Medicine & Pediatrics; Director of Palliative Medicine; Associate Program Director, Internal Med-Peds Residency, Tulane University School of Medicine, New Orleans, Louisiana, and University Medical Center of New Orleans.

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