Aussies use more antibiotics with electronic prescribing

Research published in the current edition of the Medical Journal of Australia reveals that computer-assisted prescribing is associated with a significant increase in repeat ordering of antibiotics used to treat upper respiratory tract infections, which in turn is leading to an increase in the use of these antibiotics.

"The benefits of prescribing software packages include quick access to patient records, legible prescriptions and access to evidence-based guidelines," said Dr David Newby, co-author of the study.

"But our study demonstrates that it may also have a negative effect on the quality use of medicines," he said.

Electronic prescribing takes more time than the handwritten option. So manufacturers have provided shortcuts and default settings that limit the number of keystrokes needed to generate a prescription.

"An example is a shortcut to insert the maximum quantity and maximum repeats available under the PBS with the press of a single button.

"Software manufacturers could be lobbied to change the default settings to 'no repeats'.

"Clinicians, not software companies, should make decisions each time they prescribe about the amount of medicine to order and whether a repeat is necessary.

"But there's no legislative power to enforce such a change and little incentive for the software manufacturer to do so.

"Further, there is likely to be resistance to this option from doctors, as it may slow down the prescribing process."

A second option is to remove the ability to order repeats on the PBS for some antibiotics. Patients should return to their doctor after that course if they remain unwell.

A third option is to educate doctors about the automatic functions of the prescribing software.

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT: Dr David Newby 0411 126 333 david.newby@newcastle.edu.au

Judith Tokley AMA 0408 824 306