Enhancing Fulfillment Data in Community Practices for Clinical Care and Research
This project used the eNQUIRENet electronic network to assess and improve the accessibility and utility of fulfillment (dispensing) data in community practices. All member practices were first surveyed for a formal assessment of their use of eRx and the accessibility and utility of fulfillment data in their electronic health records. Fulfillment data were then extracted from five practices that used a mixture of patient consent methods. Using this enriched understanding of the fulfillment data available in community practices, we developed, refined, and pilot tested a hypertension report using clinical and fulfillment data in one practice associated with one clinical organization and obtained qualitative input on the utility of including drug fulfillment data on clinical decision making.
Estimates of adherence to three classes of medication (antihypertensives, HMG Co-A reductase inhibitors [statins], and antidepressants) were derived and compared with benchmark data from published reports. The utility of using prescribing data and fulfillment data to identify unintended continuation and duplication of therapy for anti-hypertensives were also explored. We used questionnaires and interviews to assess the utility of the hypertension report and to determine how it may be adapted for other common conditions in primary care.