Unexpected Increase in Benzodiazepine Prescriptions Related to the Introduction of an Electronic Prescribing Tool: Evidence from Multicenter Hospital Data
Electronic Prescribing tools (e-prescribing) have shown several benefits in terms of prescribing process adequacy and health care quality in hospital settings. We hypothesize however, that an undesired effect of digitalisation, due to the easier and faster prescribing process allowing patients to sk...
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-11-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/9/4/190 |
| _version_ | 1817990640675323904 |
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| author | Rosaria Del Giorno Carmen Schneiders Kevyn Stefanelli Alessandro Ceschi Sandor Gyoerik-Lora Irene Aletto Luca Gabutti |
| author_facet | Rosaria Del Giorno Carmen Schneiders Kevyn Stefanelli Alessandro Ceschi Sandor Gyoerik-Lora Irene Aletto Luca Gabutti |
| author_sort | Rosaria Del Giorno |
| collection | DOAJ |
| description | Electronic Prescribing tools (e-prescribing) have shown several benefits in terms of prescribing process adequacy and health care quality in hospital settings. We hypothesize however, that an undesired effect of digitalisation, due to the easier and faster prescribing process allowing patients to skip face-to-face conversations with patients and nurses, is that it could facilitate the prescription of medications at high risk of overuse or abuse, such as benzodiazepines (BZDs). We conducted a panel data study to investigate, the impact of the introduction of an e-prescribing system on new BZD prescriptions in hospitalised patients in a network of five teaching hospitals. During the observation period 1 July 2014−30 April 2019, 43,320 admissions were analysed. A fixed-effects model was adopted to estimate the effect of e-prescribing on new BZD prescriptions. E-prescribing implementation was associated with a significant increase of new BZD prescriptions: absolute +1.5%, and relative +43% (<i>p</i> < 0.001). The effect was similar in males and females (respectively, absolute +2.3%, relative +65% (<i>p</i> < 0.001); absolute +1.8%, relative +58% (<i>p</i> = 0.01)) and in patients ≥70 years old (absolute +1.6%, relative +59% (<i>p</i> < 0.001)). After controlling for time-varying explanatory variables, the implementation of the e-prescribing tool showed similar significant effects. E-prescribing implementation was associated with a significant increase of new in-hospital BZD prescriptions. For classes of drugs at risk of overuse or abuse, e-prescribing should be used cautiously, to minimize the risk of over-prescriptions. Further research in other settings and countries is needed to analyse causal interactions between e-prescribing and BZD prescriptions in the hospital setting, and to promote the ultimate goal of high-value care. |
| first_indexed | 2024-04-14T01:01:51Z |
| format | Article |
| id | doaj.art-dcd68f34c8b64c35b5d7db669bae17ab |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-14T01:01:51Z |
| publishDate | 2019-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-dcd68f34c8b64c35b5d7db669bae17ab2022-12-22T02:21:23ZengMDPI AGDiagnostics2075-44182019-11-019419010.3390/diagnostics9040190diagnostics9040190Unexpected Increase in Benzodiazepine Prescriptions Related to the Introduction of an Electronic Prescribing Tool: Evidence from Multicenter Hospital DataRosaria Del Giorno0Carmen Schneiders1Kevyn Stefanelli2Alessandro Ceschi3Sandor Gyoerik-Lora4Irene Aletto5Luca Gabutti6Department of Internal Medicine, Regional Hospital of Bellinzona and Valli, 6500 Bellinzona, SwitzerlandDepartment of Internal Medicine, Regional Hospital of Bellinzona and Valli, 6500 Bellinzona, SwitzerlandDepartment of Social Sciences and Economics, Sapienza University of Rome, 00186 Rome, ItalyDivision of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, SwitzerlandDepartment of Internal Medicine, Regional Hospital of Bellinzona and Valli, 6500 Bellinzona, SwitzerlandDepartment of Internal Medicine, Regional Hospital of Bellinzona and Valli, 6500 Bellinzona, SwitzerlandDepartment of Internal Medicine, Regional Hospital of Bellinzona and Valli, 6500 Bellinzona, SwitzerlandElectronic Prescribing tools (e-prescribing) have shown several benefits in terms of prescribing process adequacy and health care quality in hospital settings. We hypothesize however, that an undesired effect of digitalisation, due to the easier and faster prescribing process allowing patients to skip face-to-face conversations with patients and nurses, is that it could facilitate the prescription of medications at high risk of overuse or abuse, such as benzodiazepines (BZDs). We conducted a panel data study to investigate, the impact of the introduction of an e-prescribing system on new BZD prescriptions in hospitalised patients in a network of five teaching hospitals. During the observation period 1 July 2014−30 April 2019, 43,320 admissions were analysed. A fixed-effects model was adopted to estimate the effect of e-prescribing on new BZD prescriptions. E-prescribing implementation was associated with a significant increase of new BZD prescriptions: absolute +1.5%, and relative +43% (<i>p</i> < 0.001). The effect was similar in males and females (respectively, absolute +2.3%, relative +65% (<i>p</i> < 0.001); absolute +1.8%, relative +58% (<i>p</i> = 0.01)) and in patients ≥70 years old (absolute +1.6%, relative +59% (<i>p</i> < 0.001)). After controlling for time-varying explanatory variables, the implementation of the e-prescribing tool showed similar significant effects. E-prescribing implementation was associated with a significant increase of new in-hospital BZD prescriptions. For classes of drugs at risk of overuse or abuse, e-prescribing should be used cautiously, to minimize the risk of over-prescriptions. Further research in other settings and countries is needed to analyse causal interactions between e-prescribing and BZD prescriptions in the hospital setting, and to promote the ultimate goal of high-value care.https://www.mdpi.com/2075-4418/9/4/190electronic prescribing toolbenzodiazepinesprescriptionshospitalincreaseunexpected |
| spellingShingle | Rosaria Del Giorno Carmen Schneiders Kevyn Stefanelli Alessandro Ceschi Sandor Gyoerik-Lora Irene Aletto Luca Gabutti Unexpected Increase in Benzodiazepine Prescriptions Related to the Introduction of an Electronic Prescribing Tool: Evidence from Multicenter Hospital Data Diagnostics electronic prescribing tool benzodiazepines prescriptions hospital increase unexpected |
| title | Unexpected Increase in Benzodiazepine Prescriptions Related to the Introduction of an Electronic Prescribing Tool: Evidence from Multicenter Hospital Data |
| title_full | Unexpected Increase in Benzodiazepine Prescriptions Related to the Introduction of an Electronic Prescribing Tool: Evidence from Multicenter Hospital Data |
| title_fullStr | Unexpected Increase in Benzodiazepine Prescriptions Related to the Introduction of an Electronic Prescribing Tool: Evidence from Multicenter Hospital Data |
| title_full_unstemmed | Unexpected Increase in Benzodiazepine Prescriptions Related to the Introduction of an Electronic Prescribing Tool: Evidence from Multicenter Hospital Data |
| title_short | Unexpected Increase in Benzodiazepine Prescriptions Related to the Introduction of an Electronic Prescribing Tool: Evidence from Multicenter Hospital Data |
| title_sort | unexpected increase in benzodiazepine prescriptions related to the introduction of an electronic prescribing tool evidence from multicenter hospital data |
| topic | electronic prescribing tool benzodiazepines prescriptions hospital increase unexpected |
| url | https://www.mdpi.com/2075-4418/9/4/190 |
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