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Why do Belgian Community Pharmacists Still Treat Electronic Prescriptions as Paper-Based?

  • Transactional Processing Systems
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Abstract

Belgium is in a transition phase from paper-based prescriptions to electronic prescriptions (ePrescriptions) during which both the paper and electronic format are valid. Since patients still get a paper proof of the ePrescription, sometimes pharmacists use the ePrescription as paper-based prescription. When the government demands a complete dematerialization, i.e. no more paper-based prescriptions, this will no longer be possible. Therefore, we questioned the frequency and reasons for treating an ePrescription as paper-based. The logged interactions in the national database were used to identify possible reasons. The tarification service Koninklijk Limburgs Apothekers Verbond (KLAV) provided prescriptions of June 2018. KLAV supports tarification for community pharmacies all over Belgium, thereby providing a representative sample for the Belgian community pharmacies. A two-stage cluster random sampling technique was applied to retrieve a subset of 10,000 prescriptions. In this subset we identified 4961 ePrescriptions (49.61%) of which 226 (4.56%, in total 2.26%) were treated as paper-based. Reasons observed for this incorrect handling are (1) non-compliance of the community pharmacist; (2) errors in software or handling of the community pharmacist; (3) errors at the prescriber side or patient tries to fraud; (4) incorrectly revoking the ePrescription; and (5) errors in software of prescriber. The main reasons for treating ePrescriptions as paper-based are non-compliance of the community pharmacist (n = 124, 54.87%) by ignoring its digital nature, and errors in software or handling of the community pharmacist (n = 85, 37.61%). Future research is necessary to investigate user opinions and to measure the impact of introducing ePrescribing in the daily routine.

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Notes

  1. The type extended delivery contains a (or multiple) product(s) that were not in stock when the patient visited the community pharmacy. The patient then receives a paper specifying the necessary products for which the delivery was extended in that pharmacy. The community pharmacist is obliged to indicate a reference to the original prescription (ePrescription or paper-based prescription). The validity period of the original prescription remains.

References

  1. eHealth Initiative Foundation (eHI), A clinician's guide to electronic prescribing. CIMM Publishing, 2008. https://www.thecimm.org/PDF/Clinician's_Guide_to_e-Prescribing_Final_100708.pdf. Accessed 1 August 2019

  2. Esmaeil Zadeh, P., and Tremblay, M. C., A review of the literature and proposed classification on e-prescribing: Functions, assimilation stages, benefits, concerns, and risks. Res. Soc. Adm. Pharm. 12(1):1–19, 2015. https://doi.org/10.1016/j.sapharm.2015.03.001.

    Article  Google Scholar 

  3. Kierkegaard, P., E-prescriptions across Europe. Heal. Technol. 3(3):205–219, 2013. https://doi.org/10.1007/s12553-012-0037-0.

    Article  Google Scholar 

  4. Pottegård, A., Schmidt, S. A. J., Wallach-Kildemoes, H., Sørensen, H. T., Hallas, J., and Schmidt, M., Data Resource Profile: The Danish National Prescription Registry. Int. J. Epidemiol. 46(3):798–798f, 2017. https://doi.org/10.1093/ije/dyw213.

    Article  PubMed  Google Scholar 

  5. Kauppinen, H., Ahonen, R., Mantyselka, P., and Timonen, J., Medication safety and the usability of electronic prescribing as perceived by physicians-A semistructured interview among primary health care physicians in Finland. J. Eval. Clin. Pract. 23(6):1187–1194, 2017. https://doi.org/10.1111/jep.12759.

    Article  PubMed  Google Scholar 

  6. Ekedahl, A., Problem prescriptions in Sweden necessitating contact with the prescriber before dispensing. Res. Soc. Adm. Pharm. 6(3):174–184, 2010. https://doi.org/10.1016/j.sapharm.2009.09.001.

    Article  Google Scholar 

  7. Samadbeik, M., Ahmadi, M., Sadoughi, F., and Garavand, A., A Comparative Review of Electronic Prescription Systems: Lessons Learned from Developed Countries. J Res Pharm Pract 6(1):3–11, 2017. https://doi.org/10.4103/2279-042X.200993.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Laius, O., Pisarev, H., Volmer, D., Koks, S., Martson, A., and Maasalu, K., Use of a national database as a tool to identify primary medication non-adherence: The Estonian ePrescription system. Res. Soc. Adm. Pharm. 14(8):776–783, 2018. https://doi.org/10.1016/j.sapharm.2017.10.003.

    Article  Google Scholar 

  9. Bruthans, J., The past and current state of the Czech outpatient electronic prescription (eRecept). Int. J. Med. Inform. 123:49–53, 2019. https://doi.org/10.1016/j.ijmedinf.2019.01.003.

    Article  PubMed  Google Scholar 

  10. Nyssen M, Putzeys T, Baert L, Buckens M, Recip-e: The Electronic Prescription System for Ambulatory Care in Belgium. The International Conference on Health Informatics (ICHI 2013), Vilamoura, 2013. https://doi.org/10.1007/978-3-319-03005-0_5

    Book  Google Scholar 

  11. Nyssen, M., and Buckens, M., Deployment of Electronic Prescriptions in Belgium. Lisbon: The Seventh International Conference on eHealth, Telemedicine, and Social Medicine (eTELEMED 2015), 2015.

    Google Scholar 

  12. Suykerbuyk, L., Robbrecht, M., De Belder, S., Bastiaens, H., Martinet, W., and De Loof, H., Patient Perceptions of Electronic Prescriptions in Belgium: An Exploratory Policy Analysis. Pharmacy Comm 6(4):130, 2018. https://doi.org/10.3390/pharmacy6040130.

    Article  Google Scholar 

  13. Sirius Insights, Aantal apotheken in België, 2017. http://siriusinsight.be/nl/whitepaper-nl/spreiding-apotheken. Accessed 1 August 2019

  14. De Proot, D., Meer dan 4.000 apothekers in besloten Facebookgroep. de Apotheker, 2017. http://www.deapotheker.be/actualiteit/meer-dan-4-000-apothekers-in-besloten-facebookgroep/article-normal-29849.html. Accessed 1 August 2019

  15. eGezondheid, eHealth platform technical incidents, 2018. eHealth Platform België. https://www.ehealth.fgov.be/nl/news/patients/2018/06. Accessed 1 August 2019

  16. Jariwala, K. S., Holmes, E. R., Banahan, 3rd, B. F., and McCaffrey, 3rd, D. J., Adoption of and experience with e-prescribing by primary care physicians. Res. Soc. Adm. Pharm. 9(1):120–128, 2012. https://doi.org/10.1016/j.sapharm.2012.04.003.

    Article  Google Scholar 

  17. Irani, Z., Weerakkody, V., Molnar, A., Lee, H., Hindi, N., and Osman, I., A user satisfaction study of the NHS Online Prescription Prepayment Certificate. Health Policy Technol 3(3):176–184, 2014. https://doi.org/10.1016/j.hlpt.2014.05.003.

    Article  Google Scholar 

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Correspondence to Sven Van Laere.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval for this study was obtained from the ethical committee of UZ Brussels (nr. 2018/218, B.U.N. 143 201 836 461). However, this article does not contain any studies with human participants or animals performed by any of the authors. No informed consent was required therefor.

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Van Laere, S., Cornu, P., Dreesen, E. et al. Why do Belgian Community Pharmacists Still Treat Electronic Prescriptions as Paper-Based?. J Med Syst 43, 327 (2019). https://doi.org/10.1007/s10916-019-1456-5

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