Zamzam Ahmed1, Nick Barber2, Yogini Jani3, Sara Garfield4, Bryony Dean Franklin5. 1. The Centre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, London, United Kingdom & UCL School of Pharmacy, London, United Kingdom; UCL School of Pharmacy, London, United Kingdom. Electronic address: zamzam.ahmed.11@ucl.ac.uk. 2. The Health Foundation, London, United Kingdom. Electronic address: nick.barber@health.org.uk. 3. UCL School of Pharmacy, London, United Kingdom; Pharmacy Department, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Medicines Use & Safety, NHS Specialist Pharmacy Service, United Kingdom. Electronic address: yogini.jani@nhs.net. 4. The Centre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, London, United Kingdom & UCL School of Pharmacy, London, United Kingdom. Electronic address: sara.garfield@imperial.nhs.uk. 5. The Centre for Medication Safety and Service Quality, Pharmacy Department, Imperial College Healthcare NHS Trust, London, United Kingdom & UCL School of Pharmacy, London, United Kingdom. Electronic address: bryony.deanfranklin@imperial.nhs.uk.
Abstract
OBJECTIVE: To examine evidence on the economic impact of electronic prescribing (EP) systems in the hospital setting. METHOD: We conducted a systematic search of MEDLINE, EMBASE, PsycINFO, International Pharmaceutical Abstracts, the NHS Economic Evaluation Database, the European Network of Health Economic Evaluation Database and Web of Science from inception to October 2013. Full and partial economic evaluations of EP or computerized provider order entry were included. We excluded studies assessing prescribing packages for specific drugs, and monetary outcomes that were not related to medicines. A checklist was used to evaluate risk of bias and evidence quality. RESULTS: The search yielded 1160 articles of which three met the inclusion criteria. Two were full economic evaluations and one a partial economic evaluation. A meta-analysis was not appropriate as studies were heterogeneous in design, economic evaluation method, interventions and outcome measures. Two studies investigated the financial impact of reducing preventable adverse drug events. The third measured savings related to various aspects of the system including those related to medication. Two studies reported positive financial effects. However the overall quality of the economic evidence was low and key details often not reported. DISCUSSION: There seems to be some evidence of financial benefits of EP in the hospital setting. However, it is not clear if evidence is transferable to other settings. Research is scarce and limited in quality, and reported methods are not always transparent. Further robust, high quality research is required to establish if hospital EP is cost effective and thus inform policy makers' decisions.
OBJECTIVE: To examine evidence on the economic impact of electronic prescribing (EP) systems in the hospital setting. METHOD: We conducted a systematic search of MEDLINE, EMBASE, PsycINFO, International Pharmaceutical Abstracts, the NHS Economic Evaluation Database, the European Network of Health Economic Evaluation Database and Web of Science from inception to October 2013. Full and partial economic evaluations of EP or computerized provider order entry were included. We excluded studies assessing prescribing packages for specific drugs, and monetary outcomes that were not related to medicines. A checklist was used to evaluate risk of bias and evidence quality. RESULTS: The search yielded 1160 articles of which three met the inclusion criteria. Two were full economic evaluations and one a partial economic evaluation. A meta-analysis was not appropriate as studies were heterogeneous in design, economic evaluation method, interventions and outcome measures. Two studies investigated the financial impact of reducing preventable adverse drug events. The third measured savings related to various aspects of the system including those related to medication. Two studies reported positive financial effects. However the overall quality of the economic evidence was low and key details often not reported. DISCUSSION: There seems to be some evidence of financial benefits of EP in the hospital setting. However, it is not clear if evidence is transferable to other settings. Research is scarce and limited in quality, and reported methods are not always transparent. Further robust, high quality research is required to establish if hospital EP is cost effective and thus inform policy makers' decisions.