EHR medication lists inaccurate, incomplete, blood tests show

A study published in JAMA Network Open has found that more than one-half of patients were taking prescription and/or OTC drugs not listed in their electronic health record (EHR). Jeffrey J.

A study published in JAMA Network Open has found that more than one-half of patients were taking prescription and/or OTC drugs not listed in their electronic health record (EHR). Jeffrey J. Sutherland, PhD, of Precera Bioscience in Franklin, TN, and colleagues also found that more than 50% of the drugs that triggered drug–drug interaction alerts in the study involved medications not listed in EHRs. The researchers developed a liquid chromatography–tandem mass spectrometry assay that measured 263 prescribed and OTC medications in a single blood sample. The researchers analyzed samples in a cross-sectional study of more than 1,300 patients involving three care settings: residual serum, gastroenterology care, and emergency department. Among the 1,346 samples, 78%–100% of medications were detected as prescribed in the EHR medication list; however, for 63% of patients there was a discrepancy between the medication list and the detected medications. According to the tests, opioid analgesics and diazepam were the most commonly detected medications without evidence of prescription. Medications used to treat cardiovascular and other chronic diseases were also often found in patients whose EHR did not list them, the authors said. The findings led the researchers to conclude: "The best determinant of whether patients take their medication is whether they take concomitant medications, demonstrating that behavior is one important parameter underlying variability in response to treatment."