4.3 Article

Twelve-month prescribing of contraceptive pill, patch, and ring before and after a standardized electronic medical record order change

Journal

CONTRACEPTION
Volume 103, Issue 1, Pages 60-63

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.contraception.2020.10.011

Keywords

Contraception; Extended supply; California legislation; Birth control; Electronic medical record; Prescription

Funding

  1. National Institutes of Health [NICHD K23 HD090323]

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After changing the default dispensing quantity in electronic medical record orders from one month to 12 months, providers prescribed a 12-month supply of contraceptive pills, patches, and rings more frequently. Providers at the medical center campus increased 12-month prescriptions after the change, while non-obstetrics/gynecology providers at community clinics also increased 12-month prescriptions, but obstetrics/gynecology providers did not.
Objective: To evaluate the proportion of 12-month contraceptive pill, patch, and ring prescriptions before and after an institution-wide change of default electronic medical record facility orders to dispensing 12-month supply. Study design: This retrospective pre-post study compares outpatient contraception prescriptions from August 10, 2019 through April 9, 2020 obtained from our institutional electronic medical record prescription database. On December 10, 2019, we facilitated a change in the default orders for dispensing self-administered hormonal contraceptives from one-month to 12-months. We evaluated the primary outcome of 12-month supply prescriptions during the four months before and after the change. We also compared 12-month supply prescriptions for pills, patch, and ring by prescriber specialty and location. Results: The dataset included 4897 distinct evaluable prescriptions for the pill, patch, or ring, with an overall increase in 12-month prescriptions from 260/2437 (10.7%) to 669/2460 (27.2%) after the order change (p < 0.001). Twelve-month pill prescriptions increased from 238/2250 (10.6%) to 607/2250 (27.0%) (p < 0.001), patch prescriptions from 6/40 (15.0%) to 21/44 (47.7%) (p = 0.002), and ring prescriptions from 16/147 (10.9%) to 41/165 (24.8%) (p = 0.001). Twelve-month prescriptions increased after the order change among all provider types at the medical center campus (194/594 [32.7%] to 329/623 [52.8%], p < 0.001). At community clinics, non-obstetrics/gynecology providers increased 12-month prescriptions after the order change (58/1616 [3.6%] to 327/1612 [20.3%], p < 0.001), but obstetrics/gynecology providers did not (8/227 [3.5%] to 13/225 [5.8%], p = 0.27). Conclusion: Providers more frequently prescribed a 12-month supply of contraceptive pills, patches, and rings after a change in the default dispensing quantity in electronic medical record orders. (C) 2020 Elsevier Inc. All rights reserved.

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