UCLA Emergency Medicine Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Acad Emerg Med. 2012 Jan;19(1):102-5. doi: 10.1111/j.1553-2712.2011.01249.x. Epub 2011 Dec 23.
The primary objectives were to assess whether electronically delivered prescriptions lead to reduced pharmacy wait time, improved patient satisfaction, and improved compliance with prescriptions. Secondary objectives included determining other reasons for noncompliance and if there was an association between prescription noncompliance and subsequent physician and emergency department (ED) visits.
In this prospective study, patients discharged from the Ronald Reagan UCLA Medical Center ED with prescriptions for nonnarcotic medications were randomized to a control group who were discharged with standard written prescriptions or an intervention group who had their prescriptions electronically delivered to the pharmacy of their choice. All study participants were contacted 7 to 31 days after ED discharge for a structured telephone interview.
Of the 454 patients enrolled, follow-up was successful for 224 patients (52.4%). Twenty-eight patients did not fill their prescriptions (12.5% noncompliance rate). The top three reasons patients stated for not picking up their medications were perceiving their prescription as unnecessary (n = 11), medication affordability (n = 5), and lack of time (n = 4). There was no difference in primary prescription noncompliance between the two study groups (p = 0.58). However, electronically delivered prescriptions significantly reduced the median pharmacy wait time, from 15 to 0 minutes (p = 0.001), and improved patient satisfaction at the pharmacy (p = 0.034). Neither subsequent physician nor ED visits were increased by primary prescription noncompliance.
Electronically delivered prescriptions significantly minimized pharmacy wait time and improved patient satisfaction at the pharmacy, but did not improve primary compliance with prescriptions.
主要目的是评估电子处方是否能减少药房等待时间、提高患者满意度和提高处方的遵从性。次要目的包括确定其他不遵从的原因，以及处方不遵从与随后的医生和急诊部（ED）就诊之间是否存在关联。
在这项前瞻性研究中，从罗纳德·里根 UCLA 医疗中心 ED 出院并开有非麻醉性药物处方的患者被随机分配到对照组，对照组出院时收到标准书面处方，或干预组收到他们选择的药房的电子处方。所有研究参与者在 ED 出院后 7 至 31 天内接受了结构化电话采访。
在 454 名入组患者中，有 224 名患者（52.4%）成功进行了随访。有 28 名患者没有取药（12.5%的不遵从率）。患者表示未取药的前三个原因是认为他们的处方不必要（n = 11）、药物可负担性（n = 5）和缺乏时间（n = 4）。两组患者的主要处方不遵从率无差异（p = 0.58）。然而，电子处方显著减少了中位数药房等待时间，从 15 分钟减少到 0 分钟（p = 0.001），并提高了患者在药房的满意度（p = 0.034）。主要处方不遵从并未增加随后的医生或 ED 就诊。
电子处方显著减少了药房等待时间，提高了患者在药房的满意度，但并未提高处方的遵从性。
