With the existence of over 20,000 FDA-approved drugs, doctors have a large variety of medications to choose from when prescribing drugs to their patients. (1) The availability of so many options can be beneficial, as there are medications for most illnesses that can be tailored to the patient, but with so many options, research has shown that it can be beneficial to have an electronic tool to guide physicians in their decision-making process.
Many pharmaceutical companies send pharmaceutical sales representatives (PSRs) to communicate with physicians, send them free gifts, sponsor their travel, and other forms of personal interactions. (2) In a study that reviewed the relationship between PSRs and physician prescription decision-making, researchers found that although physicians do not believe they are susceptible to the influence of PSRs, gifts from PSRs cause physicians to favor the company’s drug. (3) Because interactions with drug representatives start early, physicians may consistently favor new drugs advertised by these representatives instead of superior medication.
Given the multitude of medications available for providers to prescribe, an objective evidence-based tool can help improve outcomes and allow providers to stay abreast of new prescription options. This is especially important due to the everchanging field of pharmaceuticals and the innovations that are made on a consistent basis. In the World Health Organization’s eight steps for appropriate prescribing of medication, the organization writes that physicians are strongly encouraged to use online software and websites to continually stay up to date with new medication.(4) Multiple studies have shown that clinical decision support systems can help physicians avoid prescribing medication which might be harmful.(5) More research is necessary to determine how electronic support systems can help improve patient outcomes, but these studies have established that these systems lead to a reduction in potentially inappropriate medications.
In a literature review of multiple observational and experimental studies which tracked how computerized decision support systems helped providers make or change their prescription decisions, a majority of the studies that were reviewed showed a significant decrease in potentially inappropriate medications being prescribed, once providers were alerted. (6) One article found that physicians using a clinical decision support tool prescribed medication that could be potentially harmful to a patient’s renal function at a rate 42% lower than those without such a tool. (7)
Because of the positive impact prescription decision support tools can have in making medication and dosing choices that improve outcomes, Esurgi has developed LeMo, a prescription decision support tool for providers. This tool will help physicians choose a medication based on side-effect prioritization, will show providers appropriate dosing, and include up to date information about medications. These features streamlined into one electronic tool that will allow providers to make evidence-based decisions with improved accuracy and efficiency.
Do you see a need for a prescribing decision support app? Based on your knowledge and experience what added features would help providers make more accurate and effective decisions?
[1.] Commissioner, O. (n.d.). Fact Sheet: FDA at a Glance. Retrieved July 07, 2020, from https://www.fda.gov/abou fda/fda-basics/fact-sheet-fda-glance
[2.] Fickweiler, F., Fickweiler, W., & Urbach, E. (2017). Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians’ attitudes and prescribing habits: a systematic review. BMJ open, 7(9), e016408. https://doi.org/10.1136/bmjopen-2017-016408
[3.] Fickweiler, F., Fickweiler, W., & Urbach, E. (2017). Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians’ attitudes and prescribing habits: a systematic review. BMJ open, 7(9), e016408. https://doi.org/10.1136/bmjopen-2017-016408
[4.] Pollock, M., Bazaldua, O., & Dobbie, A. (2007, January 15). Appropriate Prescribing of Medications: An Eight-Step Approach. Retrieved July 08, 2020, from https://www.aafp.org/afp/2007/0115/p231.html
[5.] Scott, I. A., Pillans, P. I., Barras, M., & Morris, C. (2018). Using EMR-enabled computerized decision support systems to reduce prescribing of potentially inappropriate medications: a narrative review. Therapeutic Advances in Drug Safety, 559–573. https://doi.org/10.1177/2042098618784809
[6.] Scott, I. A., Pillans, P. I., Barras, M., & Morris, C. (2018). Using EMR-enabled computerized decision support systems to reduce prescribing of potentially inappropriate medications: a narrative review. Therapeutic Advances in Drug Safety, 559–573. https://doi.org/10.1177/2042098618784809
[7.] William L. Galanter, MD, PhD, Robert J. Didomenico, PharmD, Audrius Polikaitis, PhD, A Trial of Automated Decision Support Alerts for Contraindicated Medications Using Computerized Physician Order Entry, Journal of the American Medical Informatics Association, Volume 12, Issue 3, May 2005, Pages 269–274, https://doi.org/10.1197/jamia.M1727
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