ArticleJournal of the American Medical Informatics Association : JAMIA2016
Effects of an e-Prescribing interface redesign on rates of generic drug prescribing: exploiting default options.
Article in Journal of the American Medical Informatics Association : JAMIA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03377855 (Addressing Origins of the Opioid Epidemic by Improving Prescribing for Opioid-Naive Patients), which is not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Addressing Origins of the Opioid Epidemic by Improving Prescribing for Opioid-Naive Patients
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Public target interventions to reduce the inappropriate use of medicines or medical procedures: a systematic review.Implementation science : IS · 2020Pooled it
- Effect of an Electronic Health Record "Nudge" on Opioid Prescribing and Electronic Health Record Keystrokes in Ambulatory Care.Journal of general internal medicine · 2021Trial
- Trial
- Behavioural analysis of factors influencing prescribing for neurodegenerative diseases: A rapid review.PloS one · 2025Review
- Early experiences of integrating an artificial intelligence-based diagnostic decision support system into radiology settings: a qualitative study.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Applications of Behavioral Economics to Pharmaceutical Policymaking: A Scoping Review with Implications for Best-Value Biological Medicines.Applied health economics and health policy · 2022Article
- A Systematic Review of Nudge Interventions to Optimize Medication Prescribing.Frontiers in pharmacology · 2022Review
- Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.BMJ open · 2021Article
- Impact of implementing electronic prior authorization on medication filling in an electronic health record system in a large healthcare system.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Nudging healthcare professionals in clinical settings: a scoping review of the literature.BMC health services research · 2021Article
- Reducing day 3 baseline monitoring bloodwork and ultrasound for patients undergoing timed intercourse and intrauterine insemination treatment cycles.Fertility research and practice · 2021Article
- Optimizing Oral Medication Schedules for Inpatient Sleep: A Quality Improvement Intervention.Hospital pediatrics · 2021Article
- Rationale and design of the Novel Uses of adaptive Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) pragmatic adaptive randomized trial: a trial protocol.Implementation science : IS · 2021Article
- Article
- Engaging physicians to prescribe more cost-effectively: Blueprint for change.Canadian family physician Medecin de famille canadien · 2020Article
- Improving Hospitalized Children's Sleep by Reducing Excessive Overnight Blood Pressure Monitoring.Pediatrics · 2020Article
- Factors influencing the use of the "not for generic substitution" mention for prescriptions in primary care: a survey with general practitioners.BMC health services research · 2018Observational
- Examining patterns in medication documentation of trade and generic names in an academic family practice training centre.BMC medical education · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIncreasing the use of generic medications could help control medical costs. However, educational interventions have limited impact on prescriber behavior, and e-prescribing alerts are associated with high override rates and alert fatigue. Our objective was to evaluate the effect of a less intrusive intervention, a redesign of an e-prescribing interface that provides default options intended to "nudge" prescribers towards prescribing generic drugs.
methodsThis retrospective cohort study in an academic ambulatory multispecialty practice assessed the effects of customizing an e-prescribing interface to substitute generic equivalents for brand-name medications during order entry and allow a one-click override to order the brand-name medication.
resultsAmong drugs with generic equivalents, the proportion of generic drugs prescribed more than doubled after the interface redesign, rising abruptly from 39.7% to 95.9% (a 56.2% increase; 95% confidence interval, 56.0-56.4%; P < .001). Before the redesign, generic drug prescribing rates varied by therapeutic class, with rates as low as 8.6% for genitourinary products and 15.7% for neuromuscular drugs. After the redesign, generic drug prescribing rates for all but four therapeutic classes were above 90%: endocrine drugs, neuromuscular drugs, nutritional products, and miscellaneous products. DISCUSSION: Changing the default option in an e-prescribing interface in an ambulatory care setting was followed by large and sustained increases in the proportion of generic drugs prescribed at the practice.
conclusionsDefault options in health information technology exert a powerful effect on user behavior, an effect that can be leveraged to optimize decision making.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.