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Effects of a Computerized Prescriber Order Entry System on Pharmacist Prescribing
Stephanie Metzger1, Christopher Evernden2, Tammy J Bungard3
1, PharmD, ACPR, is with Pharmacy Services, Alberta Health Services, Edmonton, Alberta.
The Canadian Journal of Hospital Pharmacy
|March 31, 2023
Summary
Computerized prescriber order entry (CPOE) systems increase pharmacist prescribing, particularly for Schedule I medications. Pharmacists using CPOE also discontinued more orders, indicating enhanced utilization of additional prescribing authority (APA).
Area of Science:
- Pharmacy Practice
- Health Informatics
- Pharmacotherapy
Background:
- Pharmacists in Alberta possess additional prescribing authority (APA).
- University of Alberta Hospital transitioned from paper-based to computerized prescriber order entry (CPOE) systems.
Purpose of the Study:
- Quantify changes in pharmacist prescribing post-CPOE implementation.
- Compare paper-based and CPOE systems regarding drug schedule, order type, medication class, and clinical practice area.
Main Methods:
- Retrospective comparative review of pharmacist orders.
- Data collected from 2-week periods in January 2019 (paper-based) and January 2020 (CPOE).
Main Results:
- Pharmacists' daily orders increased by a mean of 3.76 with CPOE (p < 0.001).
- Schedule I medications represented a higher proportion of prescriptions in CPOE (77.7% vs. 70.5%, p < 0.001).
- Discontinuation orders significantly increased with CPOE (58.0% vs. 19.8%, p < 0.001).
Conclusions:
- CPOE systems facilitate increased pharmacist prescribing and utilization of APA.
- CPOE leads to a higher proportion of Schedule I medication prescriptions.
- Pharmacists using CPOE discontinue a greater proportion of orders.
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