ArticleJournal of the American Medical Informatics Association : JAMIA2021
Impact of implementing electronic prior authorization on medication filling in an electronic health record system in a large healthcare system.
Article in Journal of the American Medical Informatics Association : JAMIA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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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.
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Who cites it
10 citing papers in PubMed.
- Association Between Social Determinants of Health and Adherence to Antihypertensive Medications in US Patients With Uncontrolled, Treated Hypertension.Circulation. Population health and outcomes · 2026Trial
- The Triple Burden of Administrative Tasks Among US Family Medicine Physicians-A Cross-sectional Study.Journal of general internal medicine · 2026Article
- Real-World Adherence Patterns of Comprehensive Genomic Profiling to Biomarker Recommended Therapies in Patients With Advanced Non-Small Cell Lung Cancer.JCO oncology practice · 2026Article
- Could an artificial intelligence approach to prior authorization be more human?Journal of the American Medical Informatics Association : JAMIA · 2023Article
- The Impact of Electronic Health Record Interventions on Patient Access to Post-Hospital Discharge Prescriptions.Hospital pharmacy · 2023Article
- Electronic Prior Authorization for Prescription Drugs - Challenges and Opportunities for Reform.The New England journal of medicine · 2023Article
- Priorities to accelerate workflow automation in health care.Journal of the American Medical Informatics Association : JAMIA · 2022Review
- Perceptions of prior authorization by use of electronic prior authorization software: A survey of providers in the United States.Journal of managed care & specialty pharmacy · 2022Article
- Is Three Company or a Crowd? Comparing and Contrasting U.S. and EuropeanAntibiotics (Basel, Switzerland) · 2022Review
- Automated versus manual prior authorization for diabetes mellitus drugs: A retrospective study from Israel.Digital healthArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveMedications frequently require prior authorization from payers before filling is authorized. Obtaining prior authorization can create delays in filling prescriptions and ultimately reduce patient adherence to medication. Electronic prior authorization (ePA), embedded in the electronic health record (EHR), could remove some barriers but has not been rigorously evaluated. We sought to evaluate the impact of implementing an ePA system on prescription filling. MATERIALS AND
methodsePA was implemented in 2 phases in September and November 2018 in a large US healthcare system. This staggered implementation enabled the later-implementing sites to be controls. Using EHR data from all prescriptions written and linked information on whether prescriptions were filled at pharmacies, we 1:1 matched ePA prescriptions with non-ePA prescriptions for the same insurance plan, medication, and site, before and after ePA implementation, to evaluate primary adherence, or the proportion of prescriptions filled within 30 days, using generalized estimating equations. We also conducted concurrent analyses across sites during the peri-implementation period (Sept-Oct 2018).
resultsOf 74 546 eligible ePA prescriptions, 38 851 were matched with preimplementation controls. In total, 24 930 (64.2%) ePA prescriptions were filled compared with 26 731 (68.8%) control prescriptions (Adjusted Relative Risk [aRR]: 0.92, 95%CI: 0.91-0.93). Concurrent analyses revealed similar findings (64.7% for ePA vs 62.3% control prescriptions, aRR: 1.03, 95%CI: 0.98-1.09). DISCUSSION: Challenges with implementation, such as misfiring and insurance fragmentation, could have undermined its effectiveness, providing implications for other health informatics interventions deployed in outpatient care.
conclusionDespite increasing interest in implementing ePA to improve prescription filling, adoption did not change medication adherence.
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