Study Type/Setting

Methods

Outcomes

Recommendations

Source

Retrospective cohort study

Setting: Primary Care

- Medication listed in the primary care office EHR vs pharmacy claims data available through the EHR

- Identified and characterized the discrepancies between the 2 lists - 14 primary care sites providing care for over 100,000 people and the surrounding communities

- All practices share an EHR; providers can request aggregated pharmacy claims data in real time within the EHR

- The majority of patients (468 of 609; 76.8%) had at least 1 medication discrepancy.

- Patients with a discrepancy were more likely to have had a hospitalization in the past year

- Aggregated pharmacy claims data available within the provider EHR can be used to identify discrepancies at the individual level in a multi-payer setting.

- Availability of this information in real time should be made a priority

No open access version available

Author:

Comer D, Couto J, Aguiar R, Wu P, Elliott D.

Study Type/Setting

Methods

Outcomes

Recommendations

Source

Cluster-randomized trial

Setting: Primary Care

N=541; 267 Intervention vs 274 controls

- 11 primary care practices that used the same Personal Health Record (PHR)

- Intervention practices received access to a medications module promoting patients to review their documented med, identify discrepancies and generate ‘eJournals’

- The proportion of medications per patient with unexplained discrepancies was lower in the intervention arm vs the control (42% vs 51%)

- Discrepancies between documented and patient-reported medication regimens can be reduced with a PHR medication review tool linked to the provider’s medical record

Schnipper et al

Study Type/Setting

Methods

Outcomes

Recommendations

Source

A study to evaluate the efficacy of a secure webbased patient portal

Setting: Primary Care

- N= 163 patients;

- 84 Patient Gateway users vs. 79 non-users

- Sending PCP a clinical message providing patient-reported information vs. no clinical message

- A lower % of PG users’ drug regimen was reported to be correct than those of PG nonusers (54% vs 61%)

- Notifying physicians of medication discrepancies via email had no effect

- Med lists in EHRs were frequently inaccurate

- Patient access to PG was not associated with more accurate medication lists in EHR

- Clinical messages to physicians containing patient-provided medication updates did not result in physician updating the med list in EHR

Staroselsky et al