| Impact of generic substitution decision support on electronic prescribing behavior. | |
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MedLine Citation:
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PMID: 20962131 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the impact of generic substitution decision support on electronic (e-) prescribing of generic medications. DESIGN: The authors analyzed retrospective outpatient e-prescribing data from an academic medical center and affiliated network for July 1, 2005-September 30, 2008 using an interrupted time-series design to assess the rate of generic prescribing before and after implementing generic substitution decision support. To assess background secular trends, e-prescribing was compared with a concurrent random sample of hand-generated prescriptions. MEASUREMENTS: Proportion of generic medications prescribed before and after the intervention, evaluated over time, and compared with a sample of prescriptions generated without e-prescribing. RESULTS: The proportion of generic medication prescriptions increased from 32.1% to 54.2% after the intervention (22.1% increase, 95% CI 21.9% to 22.3%), with no diminution in magnitude of improvement post-intervention. In the concurrent control group, increases in proportion of generic prescriptions (29.3% to 31.4% to 37.4% in the pre-intervention, post-intervention, and end-of-study periods, respectively) were not commensurate with the intervention. There was a larger change in generic prescribing rates among authorized prescribers (24.6%) than nurses (18.5%; adjusted OR 1.38, 95% CI 1.17 to 1.63). Two years after the intervention, the proportion of generic prescribing remained significantly higher for e-prescriptions (58.1%; 95% CI 57.5% to 58.7%) than for hand-generated prescriptions ordered at the same time (37.4%; 95% CI 34.9% to 39.9%) (p<0.0001). Generic prescribing increased significantly in every specialty. CONCLUSION: Implementation of generic substitution decision support was associated with dramatic and sustained improvements in the rate of outpatient generic e-prescribing across all specialties. |
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Authors:
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Shane P Stenner; Qingxia Chen; Kevin B Johnson |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of the American Medical Informatics Association : JAMIA Volume: 17 ISSN: 1527-974X ISO Abbreviation: J Am Med Inform Assoc Publication Date: 2010 Nov-Dec |
Date Detail:
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Created Date: 2010-10-21 Completed Date: 2011-02-18 Revised Date: 2011-11-08 |
Medline Journal Info:
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Nlm Unique ID: 9430800 Medline TA: J Am Med Inform Assoc Country: United States |
Other Details:
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Languages: eng Pagination: 681-8 Citation Subset: IM |
Affiliation:
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Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. shane.stenner@vanderbilt.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Decision Support Systems, Clinical* Drug Substitution / utilization* Drugs, Generic* Electronic Prescribing* Humans Medical Order Entry Systems* Nurse's Practice Patterns* Physician's Practice Patterns* Regression Analysis Reminder Systems Retrospective Studies Tennessee User-Computer Interface |
| Grant Support | |
ID/Acronym/Agency:
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5 T15 LM007450-07/LM/NLM NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Drugs, Generic |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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