ELECTRONIC PRESCRIPTIONS NEW WEAPON IN FIGHTING OPIOID CRISIS
PrescribeIT: a new e-prescribing and information sharing system for patients, doctors, pharmacists
Health-care workers have had a front row seat to this country’s growing opioid crisis. Canada is now the second largest consumer of prescription opioids in the world, according to the Canadian Centre for Addictions. Between January 2016 and March 2019, one life was lost every two hours due to opioids.
In spite of focused efforts by healthcare and law-enforcement professionals, opioid-related deaths continue to climb every year. And although illicit opioids (especially fentanyl) can take part of the blame for the epidemic of opioidrelated deaths, prescription opioids continue to play a major role.
A study by peer-reviewed medical journal The BMJ, using data from 2016 in three Canadian provinces, found that about a third of patients had an active opioid prescription at the time of overdose. And 60 per cent had received a prescription within the last 180 days. Clearly physicians and pharmacists need to be cautious when issuing and filling opioid prescriptions. Yet they cannot ignore the needs of pain sufferers.
PrescribeIT — a national not-forprofit organization run by Canada Health Infoway and funded by Health Canada — has become part of the conversation. The service allows physicians, nurse practitioners and eventually other prescribers to transmit prescriptions electronically directly to a patient’s pharmacy of choice. In the process, it does away with paper or faxed prescriptions, reducing the risk of fraud, forgery and errors.
Out of the wrong hands
With PrescribeIT, doctors and nurse practitioners can create, renew and cancel prescriptions electronically. As a result, they’re able to write prescriptions for a small quantity of opioids, safe in the knowledge that they can order an additional supply remotely if needed. Prescriptions can also be cancelled swiftly and easily. That’s important because studies show many patients have leftover opioids after surgery (between 67 per cent and 92 per cent) which are vulnerable to theft, sale or misuse. In fact, one study reported that 21 per cent of Ontario high school students admitted to taking opioid prescription drugs for nonmedical reasons, and 72 per cent got the drugs from their own homes.
Flag potential risks
PrescribeIT allows secure two-way communication between prescribers and pharmacists, so questions or concerns about dosages and potentially dangerous drug interactions can be dealt with immediately. In combination with decision-support tools that could in the future prompt prescribers when medications might be putting patients in danger — the feature could save lives.
For example, PrescribeIT could warn prescribers when opioids are prescribed along with benzodiazepines — a potentially deadly combination. Of the 82 opioid-related deaths in New Brunswick over the last three years, 50 of the patients also had benzodiazepines in their system, according to figures from the Department of Justice and Public Safety.
When Canada Health Infoway consulted prescribers and patients with opioid experience, they found that 77 per cent supported e-prescribing as the sole option for prescribing opioids.
Controlling costs and patient information
The benefits of e-prescribing are also financial. A 2018 study by Canada Health Infoway estimated that lost or damaged paper prescriptions alone cost the Canadian economy more than $35 million.
Because PrescribeIT incorporates secure end-to-end encryption for all shared health information, patients can also rest easy knowing their information stays confidential and is only used for its explicitly intended purpose. In comparison, when the British Medical Journal tested 24 publicly available medication apps, they found that 19 of them shared personal data collected with third parties.
Patients don’t lose the element of choice. In keeping with its patientcentric focus, PrescribeIT allows patients to have their prescription delivered electronically to whichever pharmacy they choose. If their local pharmacy is not connected to PrescribeIT or if they’re not sure which pharmacy to use, they can opt for a traditional printed or faxed prescription instead.
Ultimately, e-prescribing harnesses current technology for the good of patients, health care practitioners and the system as a whole. Pharmacists and physicians interested in learning more about e-prescribing can visit prescribeit.ca.