It may be a surprising stat to some, but roughly 30 per cent of prescriptions generated in Canada by prescribers for their patients go unfilled. Reasons range from prescriptions that are lost or damaged, to the cost of the medications, to forgetfulness, to not wanting to take the medication, and many others. Medication non-adherence could result in a worsening of a patient’s condition and, potentially, more frequent hospitalization and/or emergency department visits. According to a World Health Organization report, medication non-adherence accounts for five per cent of Canadian hospital admissions and five per cent of physician visits, resulting in an additional $4 billion in health care costs annually.
Electronic prescribing using PrescribeIT™, Canada’s e-prescribing service, will enable clinicians to monitor whether prescriptions generated by prescribers are dispensed by a pharmacy. If they are not, and clinicians feel that there could be negative consequences for their patients, there is an opportunity for follow up.
While such an intervention would likely result in improved adherence rates for patients, some may feel that it infringes on patients’ autonomy. A recent study of Canadians’ perceptions of e-prescribing commissioned by Infoway found that while 81 per cent of Canadians would like to receive reminders their medication is ready for pickup at their pharmacy, only 66 per cent would want their prescriber notified if their prescriptions were not filled after seven days.
A recent paper published in Healthcare Management Forum explores the tension between patient autonomy and patient safety in more detail and presents a couple of real-life scenarios that likely occur regularly across the Canadian health care system.
We’d love to hear your thoughts on finding a balance between patient autonomy and patient safety.
Bobby: bgheorghiu@infoway-inforoute.ca
Seema: snayani@infoway-inforoute.ca