Stakeholder views on requiring diagnosis or clinical indication on e-prescriptions

Medication safety organizations have been recommending the inclusion of diagnosis or clinical indication on prescription orders for decades. However, this information is typically not provided by prescribers and shared with pharmacists, despite the availability of data fields in the most commonly used standard for electronic prescriptions.

To elucidate the views of selected industry stakeholders relative to perceived barriers to including diagnosis or indication on all electronic prescriptions.

Semistructured concept elicitation interviews identified key issues. Survey items were refined iteratively by the research team. The final instrument consisted of 34 questions intended to elicit the importance and relative priority of perceived barriers and potential solutions. A link to the Internet survey was emailed to members of the National Council for Prescription Drug Programs in February 2023, with biweekly follow-up reminders.

A total of 139 surveys were analyzed for a response rate of 9.6%. On the importance of resolving issues related to the inclusion of diagnosis or indication on e-prescriptions, a majority of respondents indicated "extremely important" or "very important" for all items except one. On level of agreement with statements about how to implement such a requirement, a majority indicated "strongly agree" or "agree" for 10 of 17 items.

Although clearly exploratory, the results of our survey suggest industry stakeholder agreement that uniform inclusion of diagnosis or clinical indication on all e-prescriptions would improve patient safety and health outcomes. A number of important questions and potential barriers must be resolved for implementation to be successful.